MEDICARE: LEDGEVIEW 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
1	310400000X	Assisted Living Facility	1966	ME
2	314000000X	Skilled Nursing Facility	1966	ME
3	385H00000X	Respite Care	1966	ME
4	313M00000X	Nursing Facility/Intermediate Care Facility	1966	ME

Other Identifiers

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

General Provider Information

NPI Number	:	1902892771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEDGEVIEW NURSING HOME INC

Provider Business Mailing Address
First Line	:	141 BETHEL RD
Second Line	:
City	:	WEST PARIS
State	:	ME
Zip	:	04289-5227
Country	:	US
Telephone Number	:	207-674-2250
Fax Number	:	207-674-3101

Provider Business Practice Location Address
First Line	:	141 BETHEL RD
Second Line	:
City	:	WEST PARIS
State	:	ME
Zip	:	04289-5227
Country	:	US
Telephone Number	:	207-674-2250
Fax Number	:	207-674-3101

Authorized Official
Title or Position	:	BUSINESS MANAGER
Name	:	MR. ROGER NEWELL WILDAY
Credential	:
Telephone Number	:	207-674-2250

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	05/13/2010

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Directions to “LEDGEVIEW NURSING HOME INC ” Practice Location

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