Healthcare Provider Details

I. General information

NPI: 1851527774
Provider Name (Legal Business Name): AROOSTOOK AGENCY ON AGING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2009
Last Update Date: 03/19/2024
Certification Date: 03/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 MAIN ST STE B
PRESQUE ISLE ME
04769-2878
US

IV. Provider business mailing address

PO BOX 1288
PRESQUE ISLE ME
04769-1288
US

V. Phone/Fax

Practice location:
  • Phone: 207-764-3396
  • Fax: 207-764-6182
Mailing address:
  • Phone: 207-764-3396
  • Fax: 207-764-6182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: CHRIS BEAULIEU
Title or Position: DIRECTOR OF HOME CARE & NUTRITION
Credential:
Phone: 207-764-3396