Provider Demographics
NPI:1033353883
Name:CARE RIDGE ESTATES INC
Entity Type:Organization
Organization Name:CARE RIDGE ESTATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VERNON
Authorized Official - Middle Name:M
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINISTRATOR
Authorized Official - Phone:207-794-6086
Mailing Address - Street 1:74 TAYLOR ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:ME
Mailing Address - Zip Code:04457-1145
Mailing Address - Country:US
Mailing Address - Phone:207-794-6086
Mailing Address - Fax:207-794-8003
Practice Address - Street 1:35 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LEE
Practice Address - State:ME
Practice Address - Zip Code:04455-4418
Practice Address - Country:US
Practice Address - Phone:207-738-4663
Practice Address - Fax:207-738-4664
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTHERN PINES CARE ESTATES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS 2043310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME432050300Medicaid