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General NPI Number Information
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NPI Number | 1235126442
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Entity Type | Organization
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Legal Business Name | ST. JOSEPHS OPERATING COMPANY INC
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 09/02/2008
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Provider Practice Location Address
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Address Line | 426 US ROUTE 1
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City | FRENCHVILLE
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State | ME
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Zip | 04745-6155
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Country | US
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Telephone | 207-543-6648
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Fax | 207-543-6118
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Provider Business Mailing Address
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Address Line | 426 US ROUTE 1 P.O. BOX 469
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City | FRENCHVILLE
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State | ME
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Zip | 04745-6155
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Country | US
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Telephone | 207-543-6648
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Fax | 207-543-6118
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BERNARD DAVIS
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Credential |
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Telephone | 207-594-4974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 36337
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License Number State | ME
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