Evergreen Manor, Inc

NPI 1356401202 - Skilled Nursing Facility - 314000000X

NPI Details
NPI 1356401202
Enumeration Date 12/11/2006
Last Updated 04/20/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name GLEN G GLEN
Position VP OF FINANCE
Phone (207) 282-5161
Fax (207) 282-5163
Practice Location
328 NORTH ST
SACO ME, 04072-1814, US
Phone (207) 282-5161
Fax (207) 282-5163
Business Location
179 LISBON ST
2ND FLOOR
LEWISTON ME, 04240-7248, US
Phone (207) 786-3554
Fax (207) 786-8507
Toxanomy
Taxonomy Code 314000000X
License State Maine
License Number 36405
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According to our database, Evergreen Manor, Inc NPI is 1356401202, taxonomy code is 314000000X and license number is 36405, license state is located at Maine. Evergreen Manor, Inc physically located at 328 North St, Saco ME, 04072-1814. NPI Number 1033115704 has the healthcare provider type.

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1356401202 NPI number is provided on an as is basis without warranty of any kind. 1356401202 is maintained by the National Plan & Provider Enumeration System. The contents of Evergreen Manor, Inc are for informational purposes only.