FREDERICK'S COUNTRY LIVING RESIDENTIAL HOME (NPI# 1386913143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386913143 |
| Entity Type | Organization |
| Organization Name | FREDERICK'S COUNTRY LIVING RESIDENTIAL HOME |
| Practice Address |
50 Palmer Rd Skowhegan ME 04976-4950 |
| Practice Telephone | 2073993486 |
| Mailing Telephone | 2073993486 |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2011-12-23 |
| Authorized Official Name | MS. MICHELE LESLIE FREDERICK (CARE GIVER) |
| Authorized Official Telephone | 2073993486 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
50 PALMER RD |
| City | SKOWHEGAN |
| State | ME |
| Zip Code | 04976-4950 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649547530 | Michele L Frederick | Military Health Care Provider | 50 Palmer Rd, Skowhegan, ME 04976-4950 | 2011-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922625573 | Alexander Jacob Tyburski | Dentist | 327 North Avenue, Skowhegan, ME 04976 | 2020-06-30 |
| 1033574348 | Northwoods Dental LLC | Dentist | 327 North Ave, Skowhegan, ME 04976 | 2015-12-31 |
| 1073988010 | Elizabeth Ann Corbin | Social Worker | 60 Water Street; Suite 202, Skowhegan, ME 04976 | 2015-12-02 |
| 1861875411 | Rebecca J. Dillingham | Registered Nurse | 1074 Canaan Road, Skowtogan, ME 04976 | 2015-07-01 |
| 1972915411 | Elisa Maria Diaz | Family Medicine | 46 Fairview Ave # 111, Skowhegan, ME 04976 | 2014-06-02 |
| 1215289277 | Alicia Bedard | Social Worker | 5 Commerce Drive, Skowhegan, ME 04976 | 2012-10-15 |
| 1942497276 | Betsy Belanger | Occupational Therapist | 23 Cedar Ridge Drive, Skowhegan, ME 04976 | 2007-10-01 |
| 1033322920 | Msad #54 | Local Education Agency (LEA) | 199 West Front Street, Skowhegan, ME 04976 | 2007-05-07 |
| 1063632263 | Shirley A Manzer | Case Manager/Care Coordinator | 78 Madison Ave, Skowhegan, ME 04976 | 2007-04-27 |
| 1275750259 | Elizabeth Doucette | Specialist | 220 Madsion Ave., Skowhegan, ME 04976 | 2007-04-19 |
| Find all providers in zip 04976 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477170843 | 3m Care LLC | Assisted Living Facility | 155 Presidential Way, Westbrook, ME 04092-2553 | 2020-07-01 |
| 1053948372 | Elm Enterprises | Assisted Living Facility | 169 Veazie St, Old Town, ME 04468-1440 | 2020-03-25 |
| 1134766009 | Legrand Amisi | Assisted Living Facility | 15 Ridge Rd, Westbrook, ME 04092-2521 | 2019-12-10 |
| 1497397368 | Sunrise Adult Family Home Care | Assisted Living Facility | 11 Ocean St, Jonesport, ME 04649-3376 | 2019-10-12 |
| 1508407016 | Blandina Chitalah | Assisted Living Facility | 342 Woodford St Unit 1, Portland, ME 04103-5608 | 2019-10-05 |
| 1962058024 | Bright Lantern Home Care | Assisted Living Facility | 14 Powsland St Apt 2, Portland, ME 04102-2622 | 2019-08-14 |
| 1417514829 | Atlantic Shores | Assisted Living Facility | 100 Marshville Rd, Harrington, ME 04643-3121 | 2019-05-21 |
| 1689133142 | Catch-wim LLC | Assisted Living Facility | 434 Roosevelt Trl, Casco, ME 04015-3515 | 2019-03-14 |
| 1750873592 | Southern Harbor Eldercare Services | Assisted Living Facility | 12 Pulpit Harbor Road, North Haven, ME 04853 | 2018-06-06 |
| 1235628934 | Woodlands Senior Living of Farmington, LLC | Assisted Living Facility | 175 Knowlton Corner Rd, Farmington, ME 04938-6200 | 2018-05-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.