Provider Demographics
NPI:1629453543
Name:SENIOR CARE CENTER
Entity Type:Organization
Organization Name:SENIOR CARE CENTER
Other - Org Name:SENIOR CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ABDULLAHI
Authorized Official - Middle Name:MIRE
Authorized Official - Last Name:ABDULLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-740-5598
Mailing Address - Street 1:37 SPRUCE ST
Mailing Address - Street 2:SUIT #1
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7322
Mailing Address - Country:US
Mailing Address - Phone:207-740-5598
Mailing Address - Fax:
Practice Address - Street 1:37 SPRUCE ST
Practice Address - Street 2:SUIT #1
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7322
Practice Address - Country:US
Practice Address - Phone:207-740-5598
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-21
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS 6678261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care