Organization
GAIA ENTERPRISES INC
Active
Other names
prior to inc was Kathleen A Tibbetts
Organization subpart
No
Provider details
NPI number
Authorized official
KATHLEEN A TIBBETTS (PRESIDENT)
(207) 799-2237
Entity
Organization
Contact information
Practice address
286 FRONT ST, SOUTH PORTLAND, ME 04106-1558
(207) 799-2237
(207) 799-0217
Mailing address
50 MARKET ST STE 1A #151, S PORTLAND, ME 04106-3666
(207) 799-2237
(207) 799-0217
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154040000
—
ME
Enumeration date
08/23/2009
Last updated
04/22/2010
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