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Organization

FALLBROOK RESIDENTIAL CARE FACILITY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GLEN G CYR (VP FINANCE)
(207) 786-3554
Entity
Organization

Contact information

Practice address
418 RAY ST, PORTLAND, ME 04103-3934
(207) 878-0788
Mailing address
179 LISBON ST, CENTERVILLE PLAZA BUILDING 2ND FLOOR, LEWISTON, ME 04240-7248
(207) 786-3554
(207) 786-8507

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ME

Other

Enumeration date
11/23/2009
Last updated
11/23/2009
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