Organization
FREDERICK'S COUNTRY LIVING RESIDENTIAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELE LESLIE FREDERICK (CARE GIVER)
(207) 399-3486
Entity
Organization
Contact information
Practice address
50 PALMER RD, SKOWHEGAN, ME 04976-4950
(207) 399-3486
Mailing address
50 PALMER RD, SKOWHEGAN, ME 04976-4950
(207) 399-3486
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Enumeration date
12/23/2011
Last updated
12/23/2011
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