Provider Demographics
NPI:1053762567
Name:ANCHOR SENIOR CARE RESIDENCE
Entity type:Organization
Organization Name:ANCHOR SENIOR CARE RESIDENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:IANDOLI-RAAB
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:207-324-4046
Mailing Address - Street 1:25 OAK ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGVALE
Mailing Address - State:ME
Mailing Address - Zip Code:04083-1927
Mailing Address - Country:US
Mailing Address - Phone:207-324-4046
Mailing Address - Fax:207-324-8849
Practice Address - Street 1:25 OAK STREET
Practice Address - Street 2:
Practice Address - City:SPRINGVALE
Practice Address - State:ME
Practice Address - Zip Code:04083
Practice Address - Country:US
Practice Address - Phone:207-324-4046
Practice Address - Fax:207-324-8849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS 6430311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home