Organization
COUNTRY VILLAGE ESTATES L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS GEORGE DUGAL (ADMINISTRATOR)
(207) 728-3570
Entity
Organization
Contact information
Practice address
260 DUGAL DRIVE, MADAWASKA, ME 04756
(207) 728-3570
(207) 728-4475
Mailing address
260 DUGAL DRIVE, MADAWASKA, ME 04756
(207) 728-3570
(207) 728-4475
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALLS3139
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
433013600
—
ME
Enumeration date
08/15/2008
Last updated
08/15/2008
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