NPI Database
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Contact Information

SEAPORT VILLAGE SKILLED NURSING CENTER LLC
19 GENERAL MOORE WAY
ELLSWORTH, ME04605-1806
 Phone: 207-667-9336
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Occupational Medicine

261QX0100X
 

Physical Therapy

261QP2000X
 

Speech-Language Pathologist

235Z00000X 15 Speech Language Pathologist
Indicates primary specialty

NPI Profile & details for SEAPORT VILLAGE SKILLED NURSING CENTER LLC

NPI # 1558351841
LBN Legal business name SEAPORT VILLAGE SKILLED NURSING CENTER LLC
Authorized official KENNETH BOWDEN - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 10/27/2005
Last updated 11/19/2014 - About 12 years ago
Identifiers
ME License # 36346
ME License # 36555
ME Medicaid 104690000
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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