Organization
MAINEHEALTH
Active
Other names
Safe Haven at St. Andrews Village
Organization subpart
No
Provider details
NPI number
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
145 EMERY LN, BOOTHBAY HARBOR, ME 04538-1963
(207) 633-0920
Mailing address
145 EMERY LN, BOOTHBAY HARBOR, ME 04538-1963
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
2019
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101560401
—
ME
Enumeration date
09/10/2018
Last updated
05/11/2020
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