MEDICARE: THE CENTER FOR ENTREPRENEURIAL STUDIES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1144976168
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE CENTER FOR ENTREPRENEURIAL STUDIES

Provider Business Mailing Address
First Line	:	156 MAIN ST
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-1922
Country	:	US
Telephone Number	:	207-779-1779
Fax Number	:

Provider Business Practice Location Address
First Line	:	156 MAIN ST
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-1922
Country	:	US
Telephone Number	:	207-779-1779
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS BONITA TOMPKINS
Credential	:
Telephone Number	:	207-779-1779

Provider Enumeration Date	:	02/28/2022
Last Update Date	:	03/04/2022

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