Healthcare Provider Details

I. General information

NPI: 1457552184
Provider Name (Legal Business Name): ELDERCARE NETWORK OF LINCOLN COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 MILL ST
WALDOBORO ME
04572-6013
US

IV. Provider business mailing address

PO BOX 652
DAMARISCOTTA ME
04543-0652
US

V. Phone/Fax

Practice location:
  • Phone: 207-832-7703
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License NumberALLS1719
License Number StateME

VIII. Authorized Official

Name: ANDREA HANDEL
Title or Position: ADMINISTRATOR
Credential:
Phone: 207-563-2148