Organization
PITTSFIELD COMMUNITY HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICK SHAW (ADMINISTRATOR)
(207) 487-6889
Entity
Organization
Contact information
Practice address
554 N MAIN ST, PITTSFIELD, ME 04967-3703
(207) 487-6889
(207) 487-4751
Mailing address
554 N MAIN ST, PITTSFIELD, ME 04967-3703
(207) 487-6889
(207) 487-4751
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALLS3186
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
432508100
MAINECARE PROVIDER NUMBER
ME
Enumeration date
07/31/2009
Last updated
07/31/2009
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