Organization
HOME FOR THE AGED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE M VACHON ED (EXECUTIVE DIRECTOR)
(207) 797-7710
Entity
Organization
Contact information
Practice address
777 STEVENS AVENUE, PORTLAND, ME 04103
(207) 797-7710
(207) 797-2558
Mailing address
777 STEVENS AVENUE, PORTLAND, ME 04103
(207) 797-7710
(207) 797-2558
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/19/2006
Last updated
08/22/2020
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