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General NPI Number Information
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NPI Number | 1932258340
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Entity Type | Organization
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Legal Business Name | SR HOME CARE SERVICES LLC
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Dates
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Enumeration Date | 01/09/2007
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 509 FOREST AVE
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City | PORTLAND
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State | ME
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Zip | 04101-1521
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Country | US
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Telephone | 207-774-6931
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Fax | 207-321-2760
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Provider Business Mailing Address
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Address Line | 101 E STATE ST
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City | KENNETT SQUARE
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State | PA
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Zip | 19348-3109
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Country | US
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Telephone | 610-925-4436
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Fax | 610-925-4351
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Authorized Official
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Title or Position | CORPORATE DIRECTOR
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Name | MARCELLA WILKINSON
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Credential |
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Telephone | 610-925-4045
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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 | 02734
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License Number State | ME
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