Organization
AVITA BRUNSWICK LLC
Active
Parent organization
NORTHBRIDGE COMPANIES
Other names
Avita of Brunswick
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
89 ADMIRAL FITCH WAY, BRUNSWICK, ME 04011
(207) 729-6222
Mailing address
89 ADMIRAL FITCH WAY, BRUNSWICK, ME 04011
(207) 729-6222
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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