Healthcare Provider Details

I. General information

NPI: 1932198850
Provider Name (Legal Business Name): FALMOUTH CONVALESCENT CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2005
Last Update Date: 06/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 FORESIDE RD
FALMOUTH ME
04105-1723
US

IV. Provider business mailing address

191 FORESIDE RD
FALMOUTH ME
04105-1723
US

V. Phone/Fax

Practice location:
  • Phone: 207-781-4714
  • Fax:
Mailing address:
  • Phone: 207-781-4714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1964
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number1964
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1964
License Number StateME
# 4
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1964
License Number StateME

VIII. Authorized Official

Name: MR. KENNETH BOWDEN
Title or Position: CEO
Credential:
Phone: 207-874-2700