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General NPI Number Information
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NPI Number | 1811130685
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Entity Type | Organization
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Legal Business Name | SPURWINK SERVICES
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 319 FOSS RD
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City | LIMERICK
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State | ME
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Zip | 04048-4306
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Country | US
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Telephone | 207-793-8354
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Fax | 207-793-3771
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Provider Business Mailing Address
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Address Line | 901 WASHINGTON AVE STE 100
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City | PORTLAND
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State | ME
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Zip | 04103-2842
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Country | US
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Telephone | 207-871-1200
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Fax | 207-871-1232
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC MEYER
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Credential | LCSW
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Telephone | 207-871-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 229881
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number | 229881
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License Number State | ME
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