Healthcare Provider Details

I. General information

NPI: 1235367228
Provider Name (Legal Business Name): NEW ENGLAND FAMILY HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PRESUMPSCOT ST. #9
PORTLAND ME
04103
US

IV. Provider business mailing address

125 PRESUMPSCOT ST. #9
PORTLAND ME
04103
US

V. Phone/Fax

Practice location:
  • Phone: 207-699-4663
  • Fax: 207-699-4261
Mailing address:
  • Phone: 207-699-4663
  • Fax: 207-699-4261

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARILYN E. FITZGERALD
Title or Position: ADMINISTRATOR
Credential:
Phone: 207-699-4261