Provider Demographics
NPI:1366273179
Name:LUXELIFE CAREGIVING OF MAINE LLC
Entity type:Organization
Organization Name:LUXELIFE CAREGIVING OF MAINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:WABWIRE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-688-4492
Mailing Address - Street 1:400 CONGRESS ST STE 300
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3553
Mailing Address - Country:US
Mailing Address - Phone:240-688-4492
Mailing Address - Fax:
Practice Address - Street 1:400 CONGRESS ST STE 300
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3553
Practice Address - Country:US
Practice Address - Phone:240-688-4492
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-13
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care