20D1101094 CLIA NUMBER - PLEASANT MEADOWS ESTATES

Laboratory Demographics

CLIA Number: 20D1101094

Facility Name: PLEASANT MEADOWS ESTATES

Facility Address:
137 PARK STREET
DOVER FOXCROFT, ME
ZIP 04426
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Facility Phone Number: 207 564-3049

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1518168632

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	20D1101094
LAB Type	Assisted Living Facility
Facility Name	PLEASANT MEADOWS ESTATES
Street	137 PARK STREET
City	DOVER FOXCROFT
State	ME
ZIP	04426
Phone	207 564-3049
CertificateType	4
CertificateEffectiveDate	6/19/2023
CertificateExpirationDate	6/18/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024