Organization
OCEAN WAY MANOR INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAURIE L TARDIFF (PRESIDENT)
(207) 354-8184
Entity
Organization
Contact information
Practice address
53 GRANITE ST, ROCKLAND, ME 04841-3031
(207) 354-8184
Mailing address
53 GRANITE ST, ROCKLAND, ME 04841-3031
(207) 354-8184
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
320900000X
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201320000
PROVIDER
ME
Enumeration date
05/14/2009
Last updated
07/09/2009
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