Provider Demographics
NPI:1194340646
Name:VERITAS CARE OF MAINE INC
Entity type:Organization
Organization Name:VERITAS CARE OF MAINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAXWELL
Authorized Official - Middle Name:
Authorized Official - Last Name:CHIKUTA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:207-807-5210
Mailing Address - Street 1:PO BOX 10112
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04104-0112
Mailing Address - Country:US
Mailing Address - Phone:207-807-5210
Mailing Address - Fax:
Practice Address - Street 1:570 BRIGHTON AVE STE 2
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-2355
Practice Address - Country:US
Practice Address - Phone:207-807-5210
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities