68 DEVONSHIRE STREET
Alzheimer Center
Portland, Maine
Provider NPI: 1427283514
Organization Information:Organization Name: 68 DEVONSHIRE STREET
Practice Location:
68 DEVONSHIRE ST PORTLAND, ME 04103 US
Tel: 207-772-2893 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
68 DEVONSHIRE ST PORTLAND, ME 04103 US
Tel: 207-772-2893 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) | ME | 2011 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
131950001 | ME | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin