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General NPI Number Information
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NPI Number | 1194340646
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Entity Type | Organization
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Legal Business Name | VERITAS CARE OF MAINE INC
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 06/10/2020
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Provider Practice Location Address
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Address Line | 570 BRIGHTON AVE STE 2
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City | PORTLAND
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State | ME
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Zip | 04102-2355
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Country | US
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Telephone | 207-807-5210
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 10112
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City | PORTLAND
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State | ME
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Zip | 04104-0112
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Country | US
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Telephone | 207-807-5210
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MAXWELL CHIKUTA
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Credential | PHD
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Telephone | 207-807-5210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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