Organization
THE SHOOTING STARS PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. RUTH HUGHES M.ED. (DIRECTOR)
(207) 883-5882
Entity
Organization
Contact information
Practice address
152 US ROUTE 1, 4, SCARBOROUGH, ME 04074-8365
(207) 883-5882
Mailing address
27 HIGH POINT RD, SCARBOROUGH, ME 04074-9027
(207) 883-8095
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
217310000
MAINECARE IDENTIFICATION NUMBER
ME
Enumeration date
05/26/2009
Last updated
05/26/2009
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