Organization
BROCK TISSUES LLC
Active
Other names
TISSUES ASSISTED LIVING
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY WESBROCK (CHIEF EXECUTIVE OFFICER)
(207) 691-5059
Entity
Organization
Contact information
Practice address
212 FOX HILL RD, ATHENS, ME 04912-4719
(207) 654-2713
Mailing address
212 FOX HILL RD, ATHENS, ME 04912-4719
(207) 654-2713
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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