Provider Demographics
NPI:1417790288
Name:TEBECK CARE, LLC
Entity type:Organization
Organization Name:TEBECK CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRI
Authorized Official - Middle Name:
Authorized Official - Last Name:IRELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-689-4277
Mailing Address - Street 1:PO BOX 264
Mailing Address - Street 2:
Mailing Address - City:MINOT
Mailing Address - State:ME
Mailing Address - Zip Code:04258-0264
Mailing Address - Country:US
Mailing Address - Phone:207-689-4277
Mailing Address - Fax:
Practice Address - Street 1:348 MINOT AVE
Practice Address - Street 2:
Practice Address - City:MINOT
Practice Address - State:ME
Practice Address - Zip Code:04258-4657
Practice Address - Country:US
Practice Address - Phone:207-689-4277
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253J00000XAgenciesFoster Care Agency
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities