Provider Demographics
NPI:1710198890
Name:ELDERCARE NETWORK OF LINCOLN COUNTY
Entity Type:Organization
Organization Name:ELDERCARE NETWORK OF LINCOLN COUNTY
Other - Org Name:BOOTHBAY GREEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-563-2148
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:DAMARISCOTTA
Mailing Address - State:ME
Mailing Address - Zip Code:04543-0652
Mailing Address - Country:US
Mailing Address - Phone:207-563-2148
Mailing Address - Fax:
Practice Address - Street 1:8 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:BOOTHBAY
Practice Address - State:ME
Practice Address - Zip Code:04537-4661
Practice Address - Country:US
Practice Address - Phone:207-633-2440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS1389310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility