Provider Demographics
NPI:1154558518
Name:CATCH A FALLING STAR
Entity type:Organization
Organization Name:CATCH A FALLING STAR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:S
Authorized Official - Last Name:HUGHES-AVERILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-945-0137
Mailing Address - Street 1:80 LINCOLN STREET
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401
Mailing Address - Country:US
Mailing Address - Phone:207-945-0137
Mailing Address - Fax:207-942-7064
Practice Address - Street 1:80 LINCOLN ST.
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401
Practice Address - Country:US
Practice Address - Phone:207-945-0137
Practice Address - Fax:207-942-7064
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CATCH A FALLING STAR
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-12
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME131350000Medicare PIN
ME131350101Medicare PIN