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68 DEVONSHIRE STREET CORP.

Assisted Living Facility

Portland, Maine

Provider NPI: 1902887060

Organization Information:
Organization Name:  68 DEVONSHIRE STREET CORP.


Practice Location:
68 DEVONSHIRE ST  PORTLAND, ME 04103 US
Tel: 207-772-2893  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility
MEALLS 1625

Other Provider Identifiers:

IssuerNumberStateType
131950000ME05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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