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SEAPORT VILLAGE SKILLED NURSING CENTER LLC NPI 1558351841


NPI Information

NPI: 1558351841
Provider Name: SEAPORT VILLAGE SKILLED NURSING CENTER LLC
Classification: Skilled Nursing Facility - 314000000X
Entity Type: Organization

CLIA Number: 20D0873335

Address:
19 GENERAL MOORE WAY
ELLSWORTH, ME
ZIP 04605
Phone: (207) 667-9336
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SEAPORT VILLAGE SKILLED NURSING CENTER LLC is a skilled nursing facility in Ellsworth, ME. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. SEAPORT VILLAGE SKILLED NURSING CENTER LLC NPI is 1558351841. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

19 GENERAL MOORE WAY
ELLSWORTH, ME
ZIP 04605-806
Phone: (207) 667-9336

The provider's authorized official is Kenneth Bowden .
The authorized official title is Ceo and has the following contact phone number (207) 874-2700.

The CLIA number assigned to this NPI record is 20D0873335 - skilled nursing facility/nursing facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/27/2005 and was last updated on 11/19/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language Pathologist36346MAINENo
2261QP2000XClinic/CenterPhysical Therapy36346MAINENo
3261QX0100XClinic/CenterOccupational Medicine36346MAINENo
4314000000XSkilled Nursing Facility36555MAINEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1104690000MEDICAIDMAINE
2205145MEDICARE OSCAR/CERTIFICATIONMAINE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.