Organization
ELMHURST, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEX KAUTZMAN (EXECUTIVE DIRECTOR)
(207) 443-9783
Entity
Organization
Contact information
Practice address
400 CENTRE ST, BATH, ME 04530-2007
(207) 443-9783
(207) 443-8887
Mailing address
400 CENTRE ST, BATH, ME 04530-2007
(207) 443-9783
(207) 443-8887
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103060000
—
ME
05
—
103060100
—
ME
05
—
103060200
—
ME
05
—
103060202
—
ME
05
—
103060300
—
ME
05
—
103060301
—
ME
05
—
103060302
—
ME
05
—
103060303
—
ME
05
—
103060304
—
ME
Enumeration date
10/18/2006
Last updated
05/17/2016
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