Provider Demographics
NPI:1619967627
Name:CUMMINGS HEALTH CARE FACILITY, INC.
Entity Type:Organization
Organization Name:CUMMINGS HEALTH CARE FACILITY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:ELLEN
Authorized Official - Last Name:GOSLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-732-4121
Mailing Address - Street 1:PO BOX 367
Mailing Address - Street 2:5 CROCKER STREET
Mailing Address - City:HOWLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04448-0367
Mailing Address - Country:US
Mailing Address - Phone:207-732-4121
Mailing Address - Fax:207-732-5133
Practice Address - Street 1:5 CROCKER STREET
Practice Address - Street 2:
Practice Address - City:HOWLAND
Practice Address - State:ME
Practice Address - Zip Code:04448-0367
Practice Address - Country:US
Practice Address - Phone:207-732-4121
Practice Address - Fax:207-732-5133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1884310400000X, 313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME=========Medicaid
ME=========Medicaid