Organization
ANGEL IN HOME SENIOR CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CONNOLLY (OWNER)
(207) 846-8722
Entity
Organization
Contact information
Practice address
724 SAWYER ST, SOUTH PORTLAND, ME 04106-4619
(207) 846-8722
Mailing address
724 SAWYER ST, SOUTH PORTLAND, ME 04106-4619
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1477044238
OPTUM
ME
Enumeration date
12/11/2020
Last updated
10/17/2023
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