Provider Demographics
NPI:1528202694
Name:ELR CARE MAINE LLC
Entity Type:Organization
Organization Name:ELR CARE MAINE LLC
Other - Org Name:SOMERSET RES CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RECEIVER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-854-2973
Mailing Address - Street 1:327 SHUSTA RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:ME
Mailing Address - Zip Code:04950-4104
Mailing Address - Country:US
Mailing Address - Phone:207-696-5453
Mailing Address - Fax:207-696-3898
Practice Address - Street 1:327 SHUSTA RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:ME
Practice Address - Zip Code:04950-4104
Practice Address - Country:US
Practice Address - Phone:207-696-5453
Practice Address - Fax:207-696-3898
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELR CARE MAINE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-04-21
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS3253310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME405380004Medicaid