North Country Associates, Inc
Organization Active NPI Skilled Nursing Facility · Madison, ME
NPI 1154481398 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1154481398
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Skilled Nursing Facility 314000000X
- License
- 36371 (ME)
- Legal business name
- NORTH COUNTRY ASSOCIATES, INC
- Practice address
- 174 Main St
Madison, ME 04950-1523 - Phone
- (207) 696-8225
- Fax
- (207) 696-5612
- 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 4
-
Susan D. Paul, MD
-
Jose A Ventura, MD, FHM, FAAFP
-
Akindele Majekodunmi, M.D., M.B.A
Medicare Care Compare: Nursing home
- Listed as
- Maplecrest Rehab & Living Center
- Overall star rating
- ★☆☆☆☆ 1 of 5
- Health inspections
- ★★☆☆☆ 2 of 5
- Staffing
- ★★★★☆ 4 of 5
- Quality measures
- ★☆☆☆☆ 1 of 5
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Oct 1, 1993
- Medicare certification status
- Active
- Certified beds
- 58 · 46.0 residents per day on average
- Chain
- North Country Associates
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 20D0090435 | Maplecrest Rehabilitation and Living Center | Certificate of waiver | Aug 31, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ME
Skilled nursing facility certification: CCN 205128
- Legal name
- NORTH COUNTRY ASSOCIATES, INC
- Doing business as
- MAPLECREST REHAB AND LIVING CENTER
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Oct 1, 1993
- Last certification
- Apr 19, 2024
- Beds
- 58
- Ownership / control type
- Corporation
- Multi-facility organization
- North Country Associates, INC.
- Organization structure
- Corporation · Proprietary
- Incorporated
- Jan 1, 1986 in ME
- Enrollment address
- 174 Main St
Madison, ME 04950-1523 - Nursing home name
- MAPLECREST REHAB & LIVING CENTER
- 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, 2008 | 50% | |
| Mary Jane Richards |
Corporate Officer |
Jan 1, 2012 | 40% |
| W-2 Managing Employee |
Jun 1, 2000 | 40% | |
| John C Orestis |
5% Or Greater Direct Ownership Interest | Jan 1, 1986 | 100% |
| Corporate Officer |
Jan 1, 1986 | 10% | |
| Randi Bento |
W-2 Managing Employee |
Jan 1, 2018 | 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 |
|---|---|---|---|---|
| O20080220000582 | ME | Part a Provider - Skilled Nursing Facility | 1759290596 | Practice locations: Madison, ME |
National Provider Directory
- Tax ID family
- North Country Associates Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 36371 | ME | Yes |
Addresses
Primary practice location
174 Main St
Madison, ME 04950-1523
Mailing address
179 Lisbon St
2ND Floor
Lewiston, ME 04240-7248
Phone (207) 786-3554
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 038428 | Other | ME | BLUE CROSS PROVIDER # |
Other names
- Maplecrest Living Center
NPI Registry JSON
{
"created_epoch": "1165795200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1154481398",
"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": "174 MAIN ST",
"city": "MADISON",
"state": "ME",
"postal_code": "049501523",
"telephone_number": "207-696-8225",
"fax_number": "207-696-5612"
}
],
"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": "36371",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS PROVIDER #",
"identifier": "038428",
"state": "ME"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Maplecrest Living Center",
"code": "3",
"type": "Doing Business As"
}
]
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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.