Provider Demographics
NPI:1053894659
Name:T.A REMINGTON ENTERPRISES LLC
Entity type:Organization
Organization Name:T.A REMINGTON ENTERPRISES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:RESIDENT CARE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIM
Authorized Official - Middle Name:M
Authorized Official - Last Name:REMINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPN, LMT
Authorized Official - Phone:207-381-0184
Mailing Address - Street 1:12 OSGOOD RD
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:ME
Mailing Address - Zip Code:04217-4826
Mailing Address - Country:US
Mailing Address - Phone:207-381-0184
Mailing Address - Fax:
Practice Address - Street 1:740 VERNON ST
Practice Address - Street 2:
Practice Address - City:ALBANY TWP
Practice Address - State:ME
Practice Address - Zip Code:04217-6221
Practice Address - Country:US
Practice Address - Phone:207-381-0184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-10
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251B00000XAgenciesCase Management