Dale Erickson
Organization Active NPI In Home Supportive Care Agency · Freeport, ME
NPI 1104054014 · NPPES record last updated Jun 30, 2009
Key facts
- NPI
- 1104054014
- Entity type
- Organization (NPI type 2)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- Legal business name
- DALE ERICKSON
- Practice address
- 40 Acorn Ridge Rd
Freeport, ME 04032-6673 - Phone
- (207) 865-4352
- NPI assigned
- Jun 30, 2009
- Organization subpart
- No
Authorized official
- Name
- Dale Erickson
- Title
- Owner
- Phone
- (207) 865-4352
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Yes |
Addresses
Primary practice location
40 Acorn Ridge Rd
Freeport, ME 04032-6673
Mailing address
40 Acorn Ridge Rd
Freeport, ME 04032-6673
NPI Registry JSON
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1246320000000",
"number": "1104054014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 ACORN RIDGE RD",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040326673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 ACORN RIDGE RD",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040326673",
"telephone_number": "207-865-4352"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DALE ERICKSON",
"organizational_subpart": "NO",
"enumeration_date": "2009-06-30",
"last_updated": "2009-06-30",
"status": "A",
"authorized_official_last_name": "ERICKSON",
"authorized_official_first_name": "DALE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "207-865-4352"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 30, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.