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General NPI Number Information
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NPI Number | 1588871545
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Entity Type | Organization
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Legal Business Name | FRYEBURG HEALTH CARE CENTER
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 70 FAIRVIEW DR
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City | FRYEBURG
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State | ME
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Zip | 04037-1524
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Country | US
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Telephone | 207-786-0111
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Fax | 207-783-5016
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Provider Business Mailing Address
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Address Line | 197 SUMMER ST
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City | AUBURN
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State | ME
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Zip | 04210-5125
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Country | US
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Telephone | 207-786-0111
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Fax | 207-783-5016
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Authorized Official
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Title or Position | OWNER
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Name | MR. DAVID R HICKS
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Credential |
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Telephone | 207-786-0111
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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 | 1942
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License Number State | ME
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