Healthcare Provider Details

I. General information

NPI: 1285605147
Provider Name (Legal Business Name): KNO-WAL-LIN HELP AT HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 PLEASANT ST
ROCKLAND ME
04841-2119
US

IV. Provider business mailing address

170 PLEASANT ST
ROCKLAND ME
04841-2119
US

V. Phone/Fax

Practice location:
  • Phone: 207-594-9561
  • Fax: 207-594-0086
Mailing address:
  • Phone: 207-594-9561
  • Fax: 207-594-0086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number2696
License Number StateME

VIII. Authorized Official

Name: MS. DONNA DEBLOIS
Title or Position: EXECUTIVE DIRECTOR
Credential: RN
Phone: 207-594-9561