Organization
COUNTRYSIDE ADULT FAMILY CARE HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY TAPEC ATIENZA (ADMINISTRATOR)
(207) 929-5787
Entity
Organization
Contact information
Practice address
1334 LONG PLAINS ROAD, BUXTON, ME 04093
(207) 929-5787
Mailing address
1334 LONG PLAINS RD, BUXTON, ME 04093-6052
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
ALLS3163
ME
Other
Enumeration date
02/22/2010
Last updated
02/22/2010
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