NPIMap

Organization Active NPI

North Country Associates, Inc

Doing business as Edgewood Living Center

  • Skilled Nursing Facility
  • Farmington, ME
National Provider Identifier
1043370273
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
2035 Issued in ME
Legal business name
NORTH COUNTRY ASSOCIATES, INC
Doing business as
Edgewood Living Center
Practice address
221 Fairbanks Rd
Farmington, ME 04938-5723
Phone
(207) 778-3386
Fax
(207) 778-5869
NPI assigned
Dec 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Glen G Cyr
Title
VP of Finance
Phone
(207) 786-3554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 2035 ME Primary

Addresses

Primary practice location

221 Fairbanks Rd
Farmington, ME 04938-5723

Mailing address

179 Lisbon St
2ND Floor
Lewiston, ME 04240-7248
Phone (207) 786-3554

Other names 1

  • Edgewood Living Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080212000630 ME Part A Provider - Skilled Nursing Facility 1759290596 Practice locations: Farmington, ME

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1043370273. Details of each certification follow.

Skilled nursing facility certification: CCN 205131

Legal name
NORTH COUNTRY ASSOCIATES, INC
Doing business as
EDGEWOOD REHAB & LIVING CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF dual certification
Participating since
Oct 1, 1993
Last certification
Oct 17, 2024
Beds
33
Ownership / control type
Corporation
Multi-facility organization
North CountryAssociates
Organization structure
CorporationProprietary
Incorporated
Jan 1, 1986 in ME
Enrollment address
221 Fairbanks Rd
Farmington, ME 04938-5723
Nursing home name
EDGEWOOD REHAB & LIVING CTR
Affiliated entity
NORTH COUNTRY ASSOCIATES

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Nursing home

Medicare Care Compare
Listed as
Edgewood Rehab & Living CtrCCN 205131 · All quality measures
Overall star rating
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
Type
Medicare and Medicaid
Ownership
For profit - Corporation
Certified
Oct 1, 1993
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
3328.6 residents per day on average
Chain
North Country Associates9 facilities in the chain

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0721365Edgewood Rehab & Living Center221 Fairbanks Road, Farmington, ME 04938Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
North Country Associates Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

221 Fairbanks Rd
Farmington, ME 04938
Phone (207) 778-3386

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Glen G Cyr Individual Corporate DirectorDirector of Finance May 1, 1998 50%
W-2 Managing EmployeeSenior Vice President of Finance Jan 1, 2012 50%
Mary Jane Richards Individual Corporate OfficerCoo Jan 1, 2012 40%
W-2 Managing EmployeeCoo Jun 1, 2000 40%
Melissa Martin Individual W-2 Managing EmployeeAdministrator Jan 1, 2017 5%
John C Orestis Individual 5% Or Greater Direct Ownership Interest Jan 1, 1986 100%
Corporate OfficerPresident Jan 1, 1986 10%

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Summer CommonsSanford, ME, CCN 205012 Skilled nursing facility Operational/Managerial Control (50%) May 1, 2021

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043370273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 LISBON ST",
            "address_2": "2ND FLOOR",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407248",
            "telephone_number": "207-786-3554",
            "fax_number": "207-786-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 FAIRBANKS RD",
            "city": "FARMINGTON",
            "state": "ME",
            "postal_code": "049385723",
            "telephone_number": "207-778-3386",
            "fax_number": "207-778-5869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CYR",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "207-786-3554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "ME",
            "license": "2035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgewood Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, ME

Sources for this page

Verify at the official NPI Registry.