Provider Demographics
NPI:1427298272
Name:GRAYMOOR
Entity type:Organization
Organization Name:GRAYMOOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRILL
Authorized Official - Middle Name:D
Authorized Official - Last Name:SPINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:207-532-0937
Mailing Address - Street 1:24 GREEN ST
Mailing Address - Street 2:
Mailing Address - City:HOULTON
Mailing Address - State:ME
Mailing Address - Zip Code:04730-1637
Mailing Address - Country:US
Mailing Address - Phone:207-532-0937
Mailing Address - Fax:207-532-2646
Practice Address - Street 1:24 GREEN ST
Practice Address - Street 2:
Practice Address - City:HOULTON
Practice Address - State:ME
Practice Address - Zip Code:04730-1637
Practice Address - Country:US
Practice Address - Phone:207-532-0937
Practice Address - Fax:207-532-2646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME409940000311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home