Organization
SOUTHERN MAINE AGENCY ON AGING
Active
Parent organization
SOUTHERN MAINE AGENCY ON AGING
Other names
The Sam L. Cohen Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN MAINE AGENCY ON AGING
Authorized official
MR. RANDALL DAVIS (CFO/COO)
(207) 396-6505
Entity
Organization
Contact information
Practice address
30 BARRA RD, BIDDEFORD, ME 04005-9459
(207) 283-0166
(207) 282-2470
Mailing address
136 US ROUTE 1, SCARBOROUGH, ME 04074-9055
(207) 396-6500
(207) 883-8249
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QA0600X
Adult Day Care Clinic/Center
Primary
ALLS3017
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109570100
—
ME
01
—
LAR003-A
EIM
ME
01
—
SOU003-A
EIM
ME
01
—
VA402(241)-P-0011
VA
ME
Enumeration date
05/29/2009
Last updated
09/03/2019
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