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General NPI Number Information
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NPI Number | 1316173750
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Entity Type | Organization
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Legal Business Name | SUPERIOR EMPLOYMENT ASSOCIATES
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 110 MAIN STREET SUITE 1214
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City | SACO
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State | ME
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Zip | 04072
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Country | US
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Telephone | 207-282-2811
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Fax | 207-282-9211
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Provider Business Mailing Address
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Address Line | 110 MAIN STREET SUITE 1214
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City | SACO
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State | ME
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Zip | 04072
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Country | US
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Telephone | 207-282-2811
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Fax | 207-282-9211
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MS. LAURA J. BOLDUC
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Credential |
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Telephone | 207-282-2811
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State | ME
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