AVITA BRUNSWICK LLC (NPI# 1992249775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992249775 |
| Entity Type | Organization |
| Organization Name | AVITA BRUNSWICK LLC |
| Other Organization Name | AVITA OF BRUNSWICK |
| Practice Address |
89 Admiral Fitch Way Brunswick ME 04011 |
| Practice Telephone | 2077296222 |
| Mailing Telephone | 2077296222 |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2016-12-13 |
| Authorized Official Name | COURTNEY FREEMAN (SENIOR EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2078440956 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHBRIDGE COMPANIES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311500000X | Alzheimer Center (Dementia Center) | ME | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Avita of Brunswick | Doing Business As Name - Organization |
| Street Address |
89 ADMIRAL FITCH WAY |
| City | BRUNSWICK |
| State | ME |
| Zip Code | 04011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093276370 | Convenientmd LLC | Clinic/Center | 193 Bath Road, Brunswick, ME 04011 | 2019-03-28 |
| 1326571241 | Psychology Specialists of Maine | Psychologist | 14 Maine St., Suite 309, Brunswick, ME 04011 | 2017-04-07 |
| 1215303433 | Mary K Kunhardt | Social Worker | 116 Maquoit Rd, Brunswick, ME 04011 | 2015-08-12 |
| 1861803843 | Gretchen Jane Stevens | Counselor | 136 Maine Street, Suite #6, Brunswick, ME 04011 | 2014-05-13 |
| 1356764567 | Kid Function, Inc. | Clinic/Center | 225 Thomas Point Road, Brunswick, ME 04011 | 2014-01-23 |
| 1356788921 | Jacques M. Reynolds | Psychiatry & Neurology | 81 Medical Center Dr # 2400, Brunswick, ME 04011 | 2013-05-23 |
| 1922369891 | Charles Russell Thorp | Pharmacist | 147 Bath Rd, Rtes 1 and 24, Merry Meeting Plaza, Brunswick, ME 04011 | 2012-06-06 |
| 1992076111 | Benjamin C. Tyau | Physician Assistant | 193 Bath Rd, Brunswick, ME 04011 | 2012-01-19 |
| 1841575339 | Bluesage Therapies Inc. | Social Worker | 214 Raymond Road, Brunswick, ME 04011 | 2011-10-15 |
| 1801197827 | Ellen H Theodores | Social Worker | 153b Park Rowe, Brunswick, ME 04011 | 2010-11-08 |
| Find all providers in zip 04011 | ||||
| Taxonomy Code | 311500000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508323247 | Northbridge Avita Brunswick II LLC | Alzheimer Center (Dementia Center) | 89 Admiral Fitch Ave, Brunswick, ME 04011-2700 | 2019-03-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710440714 | Woodlands Senior Living of Madison LLC | Alzheimer Center (Dementia Center) | 141 W River Rd Ste 400, Waterville, ME 04901-5184 | 2019-04-08 |
| 1417414152 | Northbridge Avita Wells II LLC | Alzheimer Center (Dementia Center) | 86 Sanford Rd, Wells, ME 04090-5532 | 2019-03-01 |
| 1063979706 | Northbridge Avita of Stroudwater II LLC | Alzheimer Center (Dementia Center) | 113 Landing Rd, Westbrook, ME 04092-4094 | 2019-03-01 |
| 1891239679 | Avita Wells LLC | Alzheimer Center (Dementia Center) | 86 Sanford Road, Wells, ME 04090 | 2016-12-13 |
| 1538615224 | Woodlands Senior Living of Farmington, LLC | Alzheimer Center (Dementia Center) | 175 Knowlton Corner Rd., Farmington, ME 04938 | 2016-09-01 |
| 1689044307 | St Joseph's Memory Care, Inc. | Alzheimer Center (Dementia Center) | 426 U.S. Route 1, Frenchville, ME 04745-0469 | 2015-10-07 |
| 1225411036 | Woodlands Senior Living of Lewiston, LLC | Alzheimer Center (Dementia Center) | 45 Mollison Way, Lewiston, ME 04240 | 2015-06-30 |
| 1760816276 | Avita Stroudwater, LLC | Alzheimer Center (Dementia Center) | 320 Spring Street, Westbrook, ME 04092 | 2013-09-03 |
| 1487966792 | Woodlands Senior Living of Cape Elizabeth, LLC | Alzheimer Center (Dementia Center) | 126 Scott Dyer Rd, Cape Elizabeth, ME 04107-2230 | 2010-07-02 |
| 1366592461 | Mainegeneral Health Rehabilitation & Long Term Care | Alzheimer Center (Dementia Center) | 154 Dresden Ave, Gardiner, ME 04345-2615 | 2007-01-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on AVITA BRUNSWICK LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.