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Organization

AVITA WELLS LLC

Active
Parent organization
NORTHBRIDGE COMPANIES
Other names
Avita of Wells
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHBRIDGE COMPANIES
Authorized official
COURTNEY FREEMAN (SENIOR EXECUTIVE DIRECTOR)
(207) 844-0956
Entity
Organization

Contact information

Practice address
86 SANFORD ROAD, WELLS, ME 04090
(207) 646-3444
(207) 646-5444
Mailing address
86 SANFORD ROAD, WELLS, ME 04090
(207) 646-3444
(207) 646-5444

Taxonomy

Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
ME

Other

Enumeration date
12/13/2016
Last updated
12/13/2016
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