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NPI Code Detail

MEDICARE: ST JOSEPHS REHABILITATION & RESIDENCE

MEDICARE: ST JOSEPHS REHABILITATION & RESIDENCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1310400000XAssisted Living Facility1908ME
2313M00000XNursing Facility/Intermediate Care Facility1908ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1790776110
Entity Type Code : Organization
Provider Name (Legal Business Name) : ST JOSEPHS REHABILITATION & RESIDENCE
Provider Business Mailing Address
First Line : 1133 WASHINGTON AVE
Second Line :
City : PORTLAND
State : ME
Zip : 04103-3629
Country : US
Telephone Number : 207-797-0600
Fax Number : 207-797-4168
Provider Business Practice Location Address
First Line : 1133 WASHINGTON AVE
Second Line :
City : PORTLAND
State : ME
Zip : 04103-3629
Country : US
Telephone Number : 207-797-0600
Fax Number : 207-797-4168
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. PEGGY FARRINGTON
Credential :
Telephone Number : 207-797-0600
Provider Enumeration Date : 11/03/2005
Last Update Date : 08/19/2015

Similar Medicare Providers

1871751941 — MICHELE DELISLE OTR
Practice Location Address:
1133 WASHINGTON AVE
PORTLAND, ME
04103-3629
Practice Phone: 207-797-0600
Practice Fax: 207-797-8659
1144488511 — MRS. SHERRY DAWN MCINTOSH R.P.T.
Practice Location Address:
1133 WASHINGTON AVE
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Practice Phone: 207-797-0600
Practice Fax:
1750546172 — MRS. ANN-MARIE GRIBBIN-BOUCHARD ATC, PTA
Practice Location Address:
1133 WASHINGTON AVE
PORTLAND, ME
04103-3629
Practice Phone: 207-797-0600
Practice Fax:
1326203688 — MOLLY AMIRAULT PTA
Practice Location Address:
1133 WASHINGTON AVE
PORTLAND, ME
04103-3629
Practice Phone: 207-797-0600
Practice Fax:
1699931543 — TIMOTHY JAMES RICE CCC/SLP
Practice Location Address:
1133 WASHINGTON AVE
PORTLAND, ME
04103-3629
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Practice Fax:
1932365467 — SUSAN PATRICIA SABO COTA
Practice Location Address:
1133 WASHINGTON AVE
PORTLAND, ME
04103-3629
Practice Phone: 207-797-0600
Practice Fax: 207-797-8659

Directions to “ST JOSEPHS REHABILITATION & RESIDENCE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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