Organization
CITY OF PORTLAND
Active
Other names
Barron Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JERALYN P LOGUE (FINANCE ADMINISTRATOR)
(207) 541-6544
Entity
Organization
Contact information
Practice address
1145 BRIGHTON AVE, PORTLAND, ME 04102-1025
(207) 541-6500
(207) 541-6555
Mailing address
1145 BRIGHTON AVE, PORTLAND, ME 04102-1025
(207) 541-6500
(207) 541-6555
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
36498
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136040800
—
ME
Enumeration date
02/09/2007
Last updated
06/25/2019
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