Provider Demographics
NPI:1235169616
Name:CREST VIEW MANOR
Entity Type:Organization
Organization Name:CREST VIEW MANOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:DUGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-532-3498
Mailing Address - Street 1:361 COURT ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1957
Mailing Address - Country:US
Mailing Address - Phone:207-532-3498
Mailing Address - Fax:
Practice Address - Street 1:361 COURT ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1957
Practice Address - Country:US
Practice Address - Phone:207-532-3498
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS1613310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility