SEVENTY FIVE STATE STREET is an assisted living facility in Portland, ME. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SEVENTY FIVE STATE STREET NPI is 1528201738. The provider is registered as an organization entity type.
The provider's business location address is:
75 STATE ST
PORTLAND, ME
ZIP 04101-746
Phone: (207) 772-2675
Fax: (207) 772-2896
The provider's authorized official is Anthony Forgione .
The authorized official title is President/ceo and has the following contact phone number (207) 772-2675.
The CLIA number assigned to this NPI record is 20D0906087 - assisted living facility with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 4/17/2009 and was last updated on 10/1/2009.