Provider Demographics
NPI:1427283159
Name:RICHMOND ELDERCARE COALITION
Entity type:Organization
Organization Name:RICHMOND ELDERCARE COALITION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:GIBBS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-737-8911
Mailing Address - Street 1:18 HATHORN ST
Mailing Address - Street 2:P.O. BOX 145
Mailing Address - City:RICHMOND
Mailing Address - State:ME
Mailing Address - Zip Code:04357-1161
Mailing Address - Country:US
Mailing Address - Phone:207-737-8911
Mailing Address - Fax:207-737-8102
Practice Address - Street 1:18 HATHORN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:ME
Practice Address - Zip Code:04357-1161
Practice Address - Country:US
Practice Address - Phone:207-737-8911
Practice Address - Fax:207-737-8102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEALLS 3462310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME128000000Medicaid