Organization
ELRCARE MAINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL TYLER (RECEIVER)
(207) 854-2973
Entity
Organization
Contact information
Practice address
15 MAIN STREET, PENOBSCOT, ME 04476-0015
(207) 326-4344
(207) 326-9615
Mailing address
P.O. BOX 15, 15 MAIN STREET, PENOBSCOT, ME 04476-0015
(207) 326-4344
(207) 326-9615
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2407
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405380006
—
ME
Enumeration date
06/30/2005
Last updated
10/04/2012
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