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General NPI Number Information
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NPI Number | 1477418952
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Entity Type | Organization
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Legal Business Name | BROOKHAVEN HOSPICE OF MAINE LLC
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Dates
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Enumeration Date | 12/17/2025
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Last Update Date | 12/17/2025
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Provider Practice Location Address
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Address Line | 23 SPRING ST STE A
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7701
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Country | US
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Telephone | 207-305-1537
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Fax |
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Provider Business Mailing Address
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Address Line | 1234 CHESTNUT ST STE 114
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City | NEWTON
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State | MA
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Zip | 02464-1491
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Country | US
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Telephone | 434-977-9711
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Fax | 434-235-4142
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICER
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Name | JESSE R MOORE
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Credential |
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Telephone | 857-331-6271
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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