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NPI Code Detail

MEDICARE: CARIBOU NURSING HOME INC

MEDICARE: CARIBOU NURSING HOME INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility36153ME
2313M00000XNursing Facility/Intermediate Care Facility36153ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114920097
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARIBOU NURSING HOME INC
Provider Business Mailing Address
First Line : 162 ACADEMY ST
Second Line :
City : PRESQUE ISLE
State : ME
Zip : 04769-3102
Country : US
Telephone Number : 207-764-0145
Fax Number : 207-764-7327
Provider Business Practice Location Address
First Line : 162 ACADEMY ST
Second Line :
City : PRESQUE ISLE
State : ME
Zip : 04769-3102
Country : US
Telephone Number : 207-764-0145
Fax Number : 207-764-7327
Authorized Official
Title or Position : ADMINISTRATOR
Name : MS. ROSE-MARIE C LOUTEN
Credential : MS RD
Telephone Number : 207-764-0145
Provider Enumeration Date : 05/24/2005
Last Update Date : 10/29/2009

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Directions to “CARIBOU NURSING HOME INC ” Practice Location

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