Organization
VK BANGOR, LLC
Active
Other names
Eastside Center for Health & Rehabilitation LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BARRY BOKOW (VICE PRESIDENT)
(516) 705-4802
Entity
Organization
Contact information
Practice address
516 MOUNT HOPE AVE, BANGOR, ME 04401-4215
(207) 947-6131
Mailing address
46 STAUDERMAN AVE, LYNBROOK, NY 11563-2524
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366782765
—
ME
Enumeration date
02/21/2013
Last updated
04/20/2016
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