Organization
MAINE COMMUNITY SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED H NOOR BS (CHIEF EXECUTIVE OFFICER)
(207) 312-8591
Entity
Organization
Contact information
Practice address
31 RIVER ST APT 1, LEWISTON, ME 04240-7873
(207) 312-8591
Mailing address
31 RIVER ST APT 1, LEWISTON, ME 04240-7873
(207) 312-8591
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NONE
—
ME
Enumeration date
06/14/2020
Last updated
06/14/2020
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