Provider Demographics
NPI:1477648962
Name:LINCOLNHEALTH COVES EDGE
Entity Type:Organization
Organization Name:LINCOLNHEALTH COVES EDGE
Other - Org Name:COVES EDGE NURSING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WAYNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:PRINTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-563-4476
Mailing Address - Street 1:26 SCHOONER STREET
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543
Mailing Address - Country:US
Mailing Address - Phone:207-563-4629
Mailing Address - Fax:207-563-4674
Practice Address - Street 1:26 SCHOONER STREET
Practice Address - Street 2:
Practice Address - City:DAMARISCOTTA
Practice Address - State:ME
Practice Address - Zip Code:04543
Practice Address - Country:US
Practice Address - Phone:207-563-4629
Practice Address - Fax:207-563-4674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME2037313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1477648962OtherNPI
ME1477648962-001Medicaid
ME1477648962-001Medicaid