Provider Demographics
NPI:1306080700
Name:CENTRAL MAINE AREA AGENCY ON AGING
Entity type:Organization
Organization Name:CENTRAL MAINE AREA AGENCY ON AGING
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:E
Authorized Official - Last Name:CURTIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-620-1680
Mailing Address - Street 1:1 WESTON CT STE 109
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-5543
Mailing Address - Country:US
Mailing Address - Phone:207-620-1680
Mailing Address - Fax:207-622-7857
Practice Address - Street 1:1 WESTON CT
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-5543
Practice Address - Country:US
Practice Address - Phone:207-623-0764
Practice Address - Fax:207-622-7857
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL MAINE AREA AGENCY ON AGING
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-29
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALL3225385H00000X
MEALL3226385H00000X
MEALL3278385H00000X
MEALL3229385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME105720101OtherMAINECARE BILLING PROVIDER
ME105720103OtherMAINECARE BILLING PROVIDER
ME105720100OtherMAINECARE BILLING PROVIDER
ME105720104OtherMAINECARE BILLING PROVIDER