Healthcare Provider Details

I. General information

NPI: 1255241725
Provider Name (Legal Business Name): ADAPTIVE SACO OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

392 MAIN ST
SACO ME
04072-1521
US

IV. Provider business mailing address

130 5TH AVE FL 5
NEW YORK NY
10011-4305
US

V. Phone/Fax

Practice location:
  • Phone: 207-284-0900
  • Fax:
Mailing address:
  • Phone: 508-404-3534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: SHAWN BERTRAM
Title or Position: CEO
Credential:
Phone: 508-404-3534