Organization
FREEPORT CONVALESCENT CENTER INC
Active
Other names
Hawthorne House
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH BOWDEN (CEO)
(207) 874-2700
Entity
Organization
Contact information
Practice address
6 OLD COUNTY RD, FREEPORT, ME 04032-6231
(207) 865-4782
(207) 865-1308
Mailing address
6 OLD COUNTY RD, FREEPORT, ME 04032-6231
(207) 865-4782
(207) 865-1308
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
2005
ME
261QP2000X
Physical Therapy Clinic/Center
2005
ME
261QX0100X
Occupational Medicine Clinic/Center
2005
ME
310400000X
Assisted Living Facility
2103
ME
310500000X
Mental Illness Intermediate Care Facility
2103
ME
314000000X
Skilled Nursing Facility
Primary
2005
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115110000
—
ME
05
—
120030000
—
ME
05
—
120030001
—
ME
Enumeration date
03/14/2006
Last updated
06/07/2013
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