Provider Demographics
NPI:1316173750
Name:SUPERIOR EMPLOYMENT ASSOCIATES
Entity type:Organization
Organization Name:SUPERIOR EMPLOYMENT ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:BOLDUC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-282-2811
Mailing Address - Street 1:110 MAIN STREET
Mailing Address - Street 2:SUITE 1214
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072
Mailing Address - Country:US
Mailing Address - Phone:207-282-2811
Mailing Address - Fax:207-282-9211
Practice Address - Street 1:110 MAIN STREET
Practice Address - Street 2:SUITE 1214
Practice Address - City:SACO
Practice Address - State:ME
Practice Address - Zip Code:04072
Practice Address - Country:US
Practice Address - Phone:207-282-2811
Practice Address - Fax:207-282-9211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432410700OtherBILLING PIN