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General NPI Number Information
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NPI Number | 1033353883
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Entity Type | Organization
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Legal Business Name | CARE RIDGE ESTATES INC
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Dates
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Enumeration Date | 04/23/2009
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Last Update Date | 04/23/2009
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Provider Practice Location Address
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Address Line | 35 RIDGE RD
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City | LEE
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State | ME
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Zip | 04455-4418
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Country | US
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Telephone | 207-738-4663
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Fax | 207-738-4664
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Provider Business Mailing Address
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Address Line | 74 TAYLOR ST
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City | LINCOLN
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State | ME
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Zip | 04457-1145
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Country | US
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Telephone | 207-794-6086
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Fax | 207-794-8003
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. VERNON M TAYLOR
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Credential | ADMINISTRATOR
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Telephone | 207-794-6086
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | ALLS 2043
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License Number State | ME
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