20D0649557 CLIA NUMBER - MAGNOLIA ASSISTED LIVING - ELLSWORTH

Laboratory Demographics

CLIA Number: 20D0649557

Facility Name: MAGNOLIA ASSISTED LIVING - ELLSWORTH

Facility Address:
42 BUCKSPORT ROAD
ELLSWORTH, ME
ZIP 04605
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Facility Phone Number: 207 702-0144

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1396805511

Taxonomy: 314000000X - Skilled Nursing Facility
(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.

CLIA Record

Field Name	Field Value
CLIA Number	20D0649557
LAB Type	Assisted Living Facility
Facility Name	MAGNOLIA ASSISTED LIVING - ELLSWORTH
Street	42 BUCKSPORT ROAD
City	ELLSWORTH
State	ME
ZIP	04605
Phone	207 702-0144
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024