Organization
MAS HOME CARE OF NAME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEN JOHNSON (VICE-PRESIDENT)
16032960953
Entity
Organization
Contact information
Practice address
360 HARLOW ST, BANGOR, ME 04401-4908
(207) 561-9533
(207) 561-9538
Mailing address
360 HARLOW ST, BANGOR, ME 04401-4908
(207) 561-9533
(207) 561-9538
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
MC12138
ME
Other
Enumeration date
10/25/2011
Last updated
10/25/2011
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