Provider Demographics
NPI:1447555065
Name:HEALING SPIRIT HEALTHCARE LLC
Entity type:Organization
Organization Name:HEALING SPIRIT HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAE
Authorized Official - Suffix:
Authorized Official - Credentials:BSB RN
Authorized Official - Phone:207-827-9100
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:OLD TOWN
Mailing Address - State:ME
Mailing Address - Zip Code:04468-0086
Mailing Address - Country:US
Mailing Address - Phone:207-827-9100
Mailing Address - Fax:207-827-9200
Practice Address - Street 1:276 MAIN ST
Practice Address - Street 2:
Practice Address - City:OLD TOWN
Practice Address - State:ME
Practice Address - Zip Code:04468-1529
Practice Address - Country:US
Practice Address - Phone:207-827-9100
Practice Address - Fax:207-827-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-12
Last Update Date:2011-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME251300000X, 251B00000X, 251J00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251300000XAgenciesLocal Education Agency (LEA)
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care