Provider Demographics
NPI:1164635058
Name:SCARBOROUGH TERRACE LTD. PARTNERS
Entity Type:Organization
Organization Name:SCARBOROUGH TERRACE LTD. PARTNERS
Other - Org Name:SCARBOROUGH TERRACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-885-5568
Mailing Address - Street 1:600 COMMERCE DR
Mailing Address - Street 2:
Mailing Address - City:SCARBOROUGH
Mailing Address - State:ME
Mailing Address - Zip Code:04074-7305
Mailing Address - Country:US
Mailing Address - Phone:207-885-5568
Mailing Address - Fax:207-883-2805
Practice Address - Street 1:600 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SCARBOROUGH
Practice Address - State:ME
Practice Address - Zip Code:04074-7305
Practice Address - Country:US
Practice Address - Phone:207-885-5568
Practice Address - Fax:207-883-2805
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS2368310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME#ALLS2368OtherMAINE LICENSE