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ROSS MANOR
NPI 1790910883
Alzheimer Center (Dementia Center) in Bangor, ME

Active since May 19, 2009CLIA 20D0705847 · Waiver
758 BROADWAY, BANGOR, ME 04401(207) 941-8400(207) 974-1135 Get Directions Write a Review

NPPES record last updated: May 19, 2009. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Ross Manor NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ROSS MANOR (NPI 1790910883) is a healthcare organization registered as an alzheimer center (dementia center) in Bangor, Maine and active in the NPI registry since May 2009. The organization holds a CLIA Waiver certificate valid through August 31, 2026 and lists Wanda Pelkey, Cfo, as its authorized official.

NPPES Registry Identity

NPI1790910883
Entity TypeOrganization
Primary Taxonomy311500000X
Legal Business NameROSS MANOR ASSOCIATES
Location Address758 BROADWAYBangor, ME 04401-3224
Mailing Address758 BroadwayBangor, ME 04401-3224 · (207) 941-8400 · Fax (207) 974-1135
Phone(207) 941-8400
Fax(207) 974-1135
Organization SubpartNo
Authorized OfficialWanda PelkeyCfo · (207) 874-2700
Enumeration DateMay 19, 2009
✔ NPI 1790910883 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAlzheimer Center (Dementia Center)Nursing & Custodial Care Facilities
Taxonomy Code311500000X
License✔ Licensed in ME · 1988
Definition
A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.
758 BROADWAY, Bangor, ME 04401
Open in Google Maps ↗

Other Names 1

Doing Business AsRoss Manor

Other Identifiers 1

Medicaid120640001ME

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D0705847

Ross Manor · Bangor, ME
Active · expires Aug 31, 2026
CLIA Number20D0705847
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 1, 2024
Certificate Expiration DateAugust 31, 2026
Laboratory DirectorDale C. Walker MD
Laboratory Phone(207) 941-8400
Laboratory LocationRoss Manor758 Broadway, Bangor, ME 04401
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 16

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOSHUA GRAY
Clinic/Center (Physical Therapy)
758 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 941-8400
DR. RICHARD ADAM SUKIENNIK DPT
Physical Therapist
758 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 941-8400
MICHAEL SEVERANCE OTR/L
Occupational Therapist
758 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 941-8400
MS. SANDRA L FEHER OTR/L
Occupational Therapist
758 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 941-8400
HEATHER SIMPSON
Occupational Therapist
758 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 941-8400
DR. KEVIN COX PT
Physical Medicine & Rehabilitation
758 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 941-8400
HALEY SMITH
Physical Therapist
758 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 941-8400
CANDICE G WALKER MS OTR/L
Occupational Therapist
758 BROADWAY
BANGOR, ME 04401
Penobscot County (207) 941-8400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ross Manor Associates's NPI number?

The NPI number for Ross Manor Associates is 1790910883. It was assigned to this organization in the NPPES registry on May 19, 2009. The provider is doing business as Ross Manor.

Where is Ross Manor Associates located?

Ross Manor Associates is located at 758 Broadway, Bangor, ME 04401. The listed phone number is (207) 941-8400.

What is Ross Manor Associates's specialty?

The primary specialty registered for this NPI is Alzheimer Center (Dementia Center) with taxonomy code 311500000X.

Does Ross Manor Associates hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D0705847) is associated with this NPI, valid through August 31, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Ross Manor Associates was last updated on May 19, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.