| Organization Name: | SEAPORT VILLAGE SKILLED NURSING CENTER LLC |
| NPI Number: | 1558351841 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KENNETH BOWDEN (CEO) |
| Mailing Address: | 19 General Moore Way Ellsworth |
| State: | ME US |
| Postal Code: | 046051806 |
| Phone Number: | 2076679336 |
| Fax Number: | |
| NPI Enumeration Date: | 10/27/2005 |
| NPI Last Update Date: | 11/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 36346 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |