Organization
PEREGRINE CORPORATION
Active
Other names
Project for Supported Living
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL A. PAPCIAK (FINANCIAL MANAGER)
(207) 879-0847
Entity
Organization
Contact information
Practice address
1011 FOREST AVENUE, PORTLAND, ME 04103
(207) 879-0847
(207) 857-2919
Mailing address
1011 FOREST AVENUE, PORTLAND, ME 04103
(207) 879-0847
(207) 857-2919
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124470000
—
ME
05
—
124470001
—
ME
05
—
124470100
—
ME
05
—
124470300
—
ME
05
—
124470400
—
ME
05
—
124470401
—
ME
05
—
124470402
—
ME
05
—
124470500
—
ME
Enumeration date
12/26/2006
Last updated
07/21/2009
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