Organization
WATERVILLE SNF OPERATIONS, LLC
Active
Other names
Oak Grove Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL THEODORE BERG (ASSISTANT SECRETARY)
(610) 444-6350
Entity
Organization
Contact information
Practice address
27 COOL ST, WATERVILLE, ME 04901-5221
(207) 873-0721
(207) 877-2287
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 925-4351
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
36217
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432469100
—
ME
Enumeration date
12/14/2006
Last updated
01/31/2024
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