Organization
SIESTA HAVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY C LAINEZ (OWNER/ADMINISTRATOR)
(207) 944-6328
Entity
Organization
Contact information
Practice address
340 STATE ST, BANGOR, ME 04401-5531
(207) 944-6328
(207) 942-1204
Mailing address
PO BOX 3715, BREWER, ME 04412-3715
(207) 944-6328
(207) 942-1204
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ALLA 3411
ME
Other
Enumeration date
05/29/2009
Last updated
05/29/2009
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