Organization
DEXTER MANOR ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH W BOWDEN (CEO)
(207) 874-2700
Entity
Organization
Contact information
Practice address
64 PARK ST, DEXTER, ME 04930-1470
(207) 924-5516
Mailing address
64 PARK ST, DEXTER, ME 04930-1470
(207) 924-5516
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
36344
ME
261QP2000X
Physical Therapy Clinic/Center
36344
ME
261QX0100X
Occupational Medicine Clinic/Center
36344
ME
314000000X
Skilled Nursing Facility
Primary
36625
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119080000
—
ME
Enumeration date
09/23/2005
Last updated
02/28/2018
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