Healthcare Provider Details

I. General information

NPI: 1427283159
Provider Name (Legal Business Name): RICHMOND ELDERCARE COALITION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2009
Last Update Date: 05/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 HATHORN ST
RICHMOND ME
04357-1161
US

IV. Provider business mailing address

18 HATHORN ST P.O. BOX 145
RICHMOND ME
04357-1161
US

V. Phone/Fax

Practice location:
  • Phone: 207-737-8911
  • Fax: 207-737-8102
Mailing address:
  • Phone: 207-737-8911
  • Fax: 207-737-8102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberALLS 3462
License Number StateME

VIII. Authorized Official

Name: MS. DENISE GIBBS
Title or Position: ADMINISTRATOR
Credential:
Phone: 207-737-8911