Organization
MAINEHEALTH
Active
Other names
Gregory Wing at St. Andrews Village
Organization subpart
No
Provider details
NPI number
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO, MAINEHEALTH)
(207) 662-3538
Entity
Organization
Contact information
Practice address
145 EMERY LANE, BOOTHBAY HARBOR, ME 04538
(207) 633-0920
(207) 633-1211
Mailing address
145 EMERY LN, BOOTHBAY HARBOR, ME 04538-1963
(207) 633-0920
(207) 633-1211
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
2019
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1528151065
NPI
ME
05
—
1528151065-001
—
ME
Enumeration date
10/02/2006
Last updated
01/06/2026
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