Justin Ryan Elliott

Individual provider Active NPI In Home Supportive Care Agency · Bucksport, ME

NPI 1194485474 · NPPES record last updated Dec 28, 2021

Key facts

NPI
1194485474
Entity type
Individual (NPI type 1)
Primary specialty
In Home Supportive Care Agency 253Z00000X
Practice address
597 Millvale Road
Bucksport, ME 04416
Phone
(207) 951-4915
NPI assigned
Dec 28, 2021
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X ME Yes

Addresses

Primary practice location

597 Millvale Road
Bucksport, ME 04416

Mailing address

597 Millvale Road
Bucksport, ME 04416
Phone (207) 951-4915

Other providers in Bucksport, ME

All providers in Bucksport, ME · In Home Supportive Care Agency in Maine

Sources for this page

Verify at the official NPI Registry.