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NPI Code Detail

MEDICARE: EASTER SEALS MAINE, INC

MEDICARE: EASTER SEALS MAINE, INC
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
11041C0700XClinical Social Worker

Other Identifiers

General Provider Information

NPI Number : 1922170901
Entity Type Code : Organization
Provider Name (Legal Business Name) : EASTER SEALS MAINE, INC
Provider Business Mailing Address
First Line : 555 AUBURN ST
Second Line :
City : MANCHESTER
State : NH
Zip : 03103-4803
Country : US
Telephone Number : 603-623-8863
Fax Number : 603-622-8101
Provider Business Practice Location Address
First Line : 14 ATLANTIC PL
Second Line :
City : SOUTH PORTLAND
State : ME
Zip : 04106-2316
Country : US
Telephone Number : 207-560-2894
Fax Number : 207-773-1139
Authorized Official
Title or Position : CFO
Name : ELIN TREANOR
Credential :
Telephone Number : 603-621-3462
Provider Enumeration Date : 11/14/2006
Last Update Date : 11/20/2019

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Directions to “EASTER SEALS MAINE, INC ” Practice Location

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