Organization
NORTH COUNTRY ASSOCIATES, INC
Active
Other names
Southridge Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GLEN G CYR (VP OF FINANCE)
(207) 786-3554
Entity
Organization
Contact information
Practice address
10 MAY ST, BIDDEFORD, ME 04005-2923
(207) 282-4138
(207) 282-8242
Mailing address
179 LISBON ST, 2ND FLOOR, LEWISTON, ME 04240-7248
(207) 786-3554
(207) 786-8507
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
2092
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038698
BLUE CROSS PROVIDER #
ME
Enumeration date
12/11/2006
Last updated
08/22/2020
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