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General NPI Number Information
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NPI Number | 1528690021
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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 | 02/12/2020
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Last Update Date | 02/12/2020
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Provider Practice Location Address
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Address Line | 570 BRIGHTON AVE STE B2
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City | PORTLAND
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State | ME
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Zip | 04102-2357
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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 | CHIEF EXECUTIVE OFFICER
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Name | DR. MAXWELL KAPENDA CHIKUTA
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Credential | PPA/PH PH.D
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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 | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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