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Organization

CLOVER MANOR INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHERYL A BRADLEY (CHIEF FINANCIAL OFFICER)
(207) 782-4797
Entity
Organization

Contact information

Practice address
440 MINOT AVE, AUBURN, ME 04210-4332
(207) 784-3573
Mailing address
250 GODDARD RD, SUITE A, LEWISTON, ME 04240-1000
(207) 782-4797
(207) 777-3996

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
106170000
ME
05
106170001
ME
05
106170002
ME
05
106170100
ME
Enumeration date
11/04/2005
Last updated
09/09/2013
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