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20D2194528 CLIA NUMBER - NORTHBRIDGE AVITA BRUNSWICK LLC

Laboratory Demographics

CLIA Number: 20D2194528

Facility Name: NORTHBRIDGE AVITA BRUNSWICK LLC

Facility Address:
89 ADMIRAL FITCH AVE
BRUNSWICK, ME
ZIP 04011
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Facility Phone Number: 207 729-6222

Facility Type: Assisted Living Facility

Certificate Type: Waiver
NPI Number: 1508323247

Taxonomy: 311500000X - Alzheimer Center (Dementia Center)
A freestanding facility or special care unit of a long term care facility focusing on patient care of individuals diagnosed with dementia or Alzheimer's Disease or their related diseases. Six elements of the facility/unit set it apart from other (the rest of the) facilities(y): Admission of residents with dementia (including those with Alzheimer's disease); Staff who are specially selected, trained, and supervised; Activities that are specifically designed for the cognitively impaired; A marketing of a special care unit in brochures; A high level of family involvement; and A physical environment designed to keep residents safe and segregated from other populations.

CLIA Record

Field Name Field Value
CLIA Number 20D2194528
LAB Type Assisted Living Facility
Facility Name NORTHBRIDGE AVITA BRUNSWICK LLC
Street 89 ADMIRAL FITCH AVE
City BRUNSWICK
State ME
ZIP 04011
Phone 207 729-6222
CertificateType 4
CertificateEffectiveDate 10/1/2022
CertificateExpirationDate 9/30/2024
FacilityType Waiver

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