Healthcare Provider Details

I. General information

NPI: 1124018312
Provider Name (Legal Business Name): QUARRY HILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 10/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 COMMUNITY DR
CAMDEN ME
04843-2064
US

IV. Provider business mailing address

4 WHITE ST
ROCKLAND ME
04841-2953
US

V. Phone/Fax

Practice location:
  • Phone: 207-230-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State

VIII. Authorized Official

Name: JADA BEARDSLEY
Title or Position: FISCAL SERVICES
Credential:
Phone: 207-594-6751