Organization
NORTHBRIDGE AVITA WELLS II LLC
Active
Parent organization
NORTHBRIDGE AVITA WELLS II LLC
Other names
Avita of Wells
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHBRIDGE AVITA WELLS II LLC
Authorized official
WENDY NOWOKUNSKI (PRESIDENT)
(781) 238-4856
Entity
Organization
Contact information
Practice address
86 SANFORD RD, WELLS, ME 04090-5532
(207) 646-3444
(207) 646-5444
Mailing address
86 SANFORD RD, WELLS, ME 04090-5532
(207) 646-3444
(207) 646-5444
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Enumeration date
03/01/2019
Last updated
03/01/2019
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