# 200 YEARS OLD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508524638
- **Authorized official:** MR. MAURICE HABIMFURA (REGISTERED NURSE)
- **Authorized official phone:** (207) 518-0881

## Contact information

- **Practice address:** 5 BLACKSTRAP RD, FALMOUTH, ME 04105-2223
- **Practice address phone:** (207) 518-0881
- **Mailing address:** 5 BLACKSTRAP RD, FALMOUTH, ME 04105-2223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/06/2021
- **Last updated:** 01/07/2023