Provider Demographics
NPI:1164656591
Name:SWEET SENIORS
Entity Type:Organization
Organization Name:SWEET SENIORS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MCKINNON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-746-3111
Mailing Address - Street 1:30 PINE ST
Mailing Address - Street 2:
Mailing Address - City:EAST MILLINOCKET
Mailing Address - State:ME
Mailing Address - Zip Code:04430-1120
Mailing Address - Country:US
Mailing Address - Phone:207-746-3111
Mailing Address - Fax:
Practice Address - Street 1:30 PINE ST
Practice Address - Street 2:
Practice Address - City:EAST MILLINOCKET
Practice Address - State:ME
Practice Address - Zip Code:04430-1120
Practice Address - Country:US
Practice Address - Phone:207-746-3111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS 3553310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility