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General NPI Number Information
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NPI Number | 1114815891
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Entity Type | Organization
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Legal Business Name | SOUTHERN MAINE SENIOR SUPPORT
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 928 DUCK POND RD
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City | WESTBROOK
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State | ME
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Zip | 04092-2512
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Country | US
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Telephone | 207-303-2926
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Fax |
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Provider Business Mailing Address
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Address Line | 928 DUCK POND RD
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City | WESTBROOK
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State | ME
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Zip | 04092-2512
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Country | US
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Telephone | 207-303-2926
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL P FLAHERTY
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Credential |
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Telephone | 207-671-1005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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