North Country Associates, Inc
Organization Active NPI Skilled Nursing Facility · Farmington, ME
NPI 1043370273 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1043370273
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 2035 (ME)
- Legal business name
- NORTH COUNTRY ASSOCIATES, INC
- Practice address
- 221 Fairbanks Rd
Farmington, ME 04938-5723 - Phone
- (207) 778-3386
- Fax
- (207) 778-5869
- NPI assigned
- Dec 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Glen G Cyr
- Title
- VP of Finance
- Phone
- (207) 786-3554
Owned or controlled facilities with NPI records 1
Other NPIs with the same Medicare PAC ID 4
Corporate family (same tax ID) 7
Practitioners 1
Affiliated clinicians 1
Medicare Care Compare: Nursing home
- Listed as
- Edgewood Rehab & Living Ctr
- 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
- Active
- Certified beds
- 33 · 28.6 residents per day on average
- Chain
- North Country Associates
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 20D0721365 | Edgewood Rehab & Living Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
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
- Corporation · Proprietary
- 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
All disclosed owners & managing parties 4
| Name | Role | Since | Share |
|---|---|---|---|
| Glen G Cyr |
Corporate Director |
May 1, 1998 | 50% |
| W-2 Managing Employee |
Jan 1, 2012 | 50% | |
| Mary Jane Richards |
Corporate Officer |
Jan 1, 2012 | 40% |
| W-2 Managing Employee |
Jun 1, 2000 | 40% | |
| Melissa Martin |
W-2 Managing Employee |
Jan 1, 2017 | 5% |
| John C Orestis |
5% Or Greater Direct Ownership Interest | Jan 1, 1986 | 100% |
| Corporate Officer |
Jan 1, 1986 | 10% |
All facility ownership & control disclosures 1
| Facility | Type | Role | Since |
|---|---|---|---|
| Summer Commons |
Skilled nursing facility | Operational/Managerial Control (50%) | May 1, 2021 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080212000630 | ME | Part a Provider - Skilled Nursing Facility | 1759290596 | Practice locations: Farmington, ME |
National Provider Directory
- Tax ID family
- North Country Associates Inc
Locations
221 Fairbanks Rd
Farmington, ME 04938
Phone (207) 778-3386
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 2035 | ME | Yes |
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 identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038426 | Other | ME | BLUE CROSS PROVIDER # |
Other names
- Edgewood Living Center
Other providers in Farmington, ME
- Jay A Naliboff
- Michele Lea Nelson
- New Communities, Inc.
- Yannick N Nkeng
- Emily Elizabeth Normandin
- North Country Associates, Inc
- Northern Eye Care P a
- Betsy Cook Norton
- Troy A Norton
- Robert M O'Reilly
All providers in Farmington, ME · Skilled Nursing Facility in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.