Healthcare Provider Details

I. General information

NPI: 1679564017
Provider Name (Legal Business Name): MAINEGENERAL HEALTH REHABILITATION & LONG TERM CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 GLENRIDGE DRIVE
AUGUSTA ME
04330-6606
US

IV. Provider business mailing address

40 GLENRIDGE DRIVE
AUGUSTA ME
04330-6606
US

V. Phone/Fax

Practice location:
  • Phone: 207-626-2600
  • Fax: 207-621-0277
Mailing address:
  • Phone: 207-626-2600
  • Fax: 207-621-0277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberAT965
License Number StateME

VIII. Authorized Official

Name: MR. GREGORY PIZZO
Title or Position: DIRECTOR OF FINANCE
Credential: MBA
Phone: 207-861-3451