Provider Demographics
NPI:1669065363
Name:SANFORD SENIOR CARE OPERATIONS, LLC
Entity type:Organization
Organization Name:SANFORD SENIOR CARE OPERATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VP FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:GLEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CYR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-786-3554
Mailing Address - Street 1:PO BOX 1408
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04243-1408
Mailing Address - Country:US
Mailing Address - Phone:207-786-3554
Mailing Address - Fax:207-786-8507
Practice Address - Street 1:21 JUNE STREET
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:ME
Practice Address - Zip Code:04073-0424
Practice Address - Country:US
Practice Address - Phone:207-786-3554
Practice Address - Fax:207-786-8507
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care