Provider Demographics
NPI:1720167901
Name:NOLI TRPINAWZK CORP
Entity Type:Organization
Organization Name:NOLI TRPINAWZK CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:E
Authorized Official - Last Name:KNOX-NICOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-817-7400
Mailing Address - Street 1:2 SARAHS SPRING LN
Mailing Address - Street 2:
Mailing Address - City:INDIAN ISLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04468-1270
Mailing Address - Country:US
Mailing Address - Phone:207-827-0968
Mailing Address - Fax:207-827-4016
Practice Address - Street 1:2 SARAHS SPRING LN
Practice Address - Street 2:
Practice Address - City:INDIAN ISLAND
Practice Address - State:ME
Practice Address - Zip Code:04468-1270
Practice Address - Country:US
Practice Address - Phone:207-827-0968
Practice Address - Fax:207-827-4016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS 2138310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME4318879200Medicaid
ME4318879200Medicaid