Healthcare Provider Details

I. General information

NPI: 1568771947
Provider Name (Legal Business Name): ARDENT GENERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2010
Last Update Date: 04/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

754A ALFRED RD
ARUNDEL ME
04046-8708
US

IV. Provider business mailing address

754A ALFRED RD
ARUNDEL ME
04046-8708
US

V. Phone/Fax

Practice location:
  • Phone: 207-710-0987
  • Fax: 207-710-0986
Mailing address:
  • Phone: 207-710-0987
  • Fax: 207-710-0986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333300000X
TaxonomyEmergency Response System Companies
License Number
License Number State

VIII. Authorized Official

Name: JOHANNA LEE GILLAND
Title or Position: DIRECTOR OF OPERATIONS
Credential: MACCCSLP
Phone: 207-710-0987