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General NPI Number Information
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NPI Number | 1285960831
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Entity Type | Organization
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Legal Business Name | ATLANTIC HOME HEALTH, INC
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Dates
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Enumeration Date | 11/02/2009
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 30 FOREST FALLS DR STE 5
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City | YARMOUTH
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State | ME
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Zip | 04096-6983
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Country | US
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Telephone | 188-888-0619
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Fax | 207-847-2017
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Provider Business Mailing Address
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Address Line | 30 FOREST FALLS DR STE 5
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City | YARMOUTH
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State | ME
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Zip | 04096-6983
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Country | US
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Telephone | 188-888-0619
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Fax | 207-847-2017
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Authorized Official
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Title or Position | MANAGER
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Name | MRS. MANDY ROSE BOUDREAUX
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Credential |
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Telephone | 18888806193
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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 | 02919
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License Number State | ME
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