Provider Demographics
NPI:1023172145
Name:INDEPENDENCE ADVOCATES OF MAINE, INC.
Entity type:Organization
Organization Name:INDEPENDENCE ADVOCATES OF MAINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:T
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-866-3769
Mailing Address - Street 1:PO BOX 457
Mailing Address - Street 2:
Mailing Address - City:ORONO
Mailing Address - State:ME
Mailing Address - Zip Code:04473-0457
Mailing Address - Country:US
Mailing Address - Phone:207-866-3769
Mailing Address - Fax:207-866-4982
Practice Address - Street 1:2 HILLSIDE RD
Practice Address - Street 2:
Practice Address - City:ORONO
Practice Address - State:ME
Practice Address - Zip Code:04473-4459
Practice Address - Country:US
Practice Address - Phone:207-866-3769
Practice Address - Fax:207-866-3769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME36469315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities