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General NPI Number Information
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NPI Number | 1811882855
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Entity Type | Organization
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Legal Business Name | CARIBOU HEALTHCARE CENTER LLC
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Dates
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Enumeration Date | 06/10/2025
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Last Update Date | 06/10/2025
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Provider Practice Location Address
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Address Line | 10 BERNADETTE ST
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City | CARIBOU
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State | ME
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Zip | 04736-2038
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Country | US
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Telephone | 207-498-3102
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Fax |
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Provider Business Mailing Address
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Address Line | 100 WATERMAN DR STE 401
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2880
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Country | US
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Telephone | 207-619-7942
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | WANDA J PELKEY
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Credential |
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Telephone | 207-619-7942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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