Provider Demographics
NPI:1912423930
Name:78 SCOTT DYER ROAD OPERATOR LLC
Entity Type:Organization
Organization Name:78 SCOTT DYER ROAD OPERATOR LLC
Other - Org Name:THE LANDING AT CAPE ELIZABETH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:H
Authorized Official - Last Name:STEPHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-943-7747
Mailing Address - Street 1:78 SCOTT DYER RD
Mailing Address - Street 2:
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-2200
Mailing Address - Country:US
Mailing Address - Phone:207-799-7332
Mailing Address - Fax:
Practice Address - Street 1:78 SCOTT DYER RD
Practice Address - Street 2:
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-2200
Practice Address - Country:US
Practice Address - Phone:207-799-7332
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility