ST JOSEPHS REHABILITATION & RESIDENCE
Assisted Living Facility
Portland, Maine
Provider NPI: 1790776110
Organization Information:Organization Name: ST JOSEPHS REHABILITATION & RESIDENCE
Practice Location:
1133 WASHINGTON AVE PORTLAND, ME 04103 US
Tel: 207-797-0600 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:
1133 WASHINGTON AVE PORTLAND, ME 04103 US
Tel: 207-797-0600 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 310400000X | Nursing & Custodial Care Facilities Assisted Living Facility | ME | 1908 |
Y | 313M00000X | Nursing & Custodial Care Facilities Nursing Facility/Intermediate Care Facility | ME | 1908 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
107380001 | ME | 05 | |
107380000 | ME | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin