Healthcare Provider Details

I. General information

NPI: 1497642771
Provider Name (Legal Business Name): VOP GORHAM LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 NEW PORTLAND RD
GORHAM ME
04038-1542
US

IV. Provider business mailing address

50 NEW PORTLAND RD
GORHAM ME
04038-1542
US

V. Phone/Fax

Practice location:
  • Phone: 207-839-5757
  • Fax:
Mailing address:
  • Phone: 207-839-5757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CHRISTIAN N. CUMMINGS
Title or Position: PRESIDENT
Credential:
Phone: 502-357-9000