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 RD, BUXTON, ME 04093-6052
(207) 929-5787
Mailing address
1334 LONG PLAINS RD, BUXTON, ME 04093-6052
(207) 929-5787
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALLS3163
ME
Other
Enumeration date
04/24/2009
Last updated
04/24/2009
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