Provider Demographics
NPI:1124825807
Name:WEST RESIDENTIAL CARE L.L.C.
Entity type:Organization
Organization Name:WEST RESIDENTIAL CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:ODLUM
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:207-275-8949
Mailing Address - Street 1:56 CHAMBERLAIN ST
Mailing Address - Street 2:
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1902
Mailing Address - Country:US
Mailing Address - Phone:207-275-8949
Mailing Address - Fax:
Practice Address - Street 1:56 CHAMBERLAIN ST
Practice Address - Street 2:
Practice Address - City:BREWER
Practice Address - State:ME
Practice Address - Zip Code:04412-1902
Practice Address - Country:US
Practice Address - Phone:207-275-8949
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness