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General NPI Number Information
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NPI Number | 1497507099
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Entity Type | Organization
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Legal Business Name | HOPE FAMILY SUPPORT SERVICES LLC
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Dates
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Enumeration Date | 04/05/2024
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 270 LISBON ST
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City | LEWISTON
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State | ME
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Zip | 04240-7705
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Country | US
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Telephone | 207-402-9469
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 76
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City | LEWISTON
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State | ME
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Zip | 04243-0076
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Country | US
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Telephone | 207-402-9469
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KHASIN ABDISALAN SABAN
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Credential |
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Telephone | 207-402-9469
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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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