Provider Demographics
NPI:1154565968
Name:HOME SUPPORT SERVICES, LLC
Entity type:Organization
Organization Name:HOME SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOYES
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:207-892-1454
Mailing Address - Street 1:PO BOX 1899
Mailing Address - Street 2:
Mailing Address - City:WINDHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04062-1899
Mailing Address - Country:US
Mailing Address - Phone:207-892-4154
Mailing Address - Fax:207-892-1452
Practice Address - Street 1:110A TANDBERG TRL
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:ME
Practice Address - Zip Code:04062-5206
Practice Address - Country:US
Practice Address - Phone:207-892-1454
Practice Address - Fax:207-892-1452
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care