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Organization
68 DEVONSHIRE STREET CORP.
Active
Organization
68 DEVONSHIRE STREET CORP.
Active
Other names
Portland Center for Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH BOWDEN (CEO)
(207) 874-2700
Entity
Organization
Contact information
Practice address
68 DEVONSHIRE ST, PORTLAND, ME 04103-4431
(207) 772-2893
Mailing address
68 DEVONSHIRE ST, PORTLAND, ME 04103-4431
(207) 772-2893
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALLS 1625
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131950000
—
ME
Enumeration date
11/07/2005
Last updated
05/19/2009
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