Provider Demographics
NPI:1518546324
Name:WATERVILLE CENTER FOR HEALTH AND REHAB LLC
Entity Type:Organization
Organization Name:WATERVILLE CENTER FOR HEALTH AND REHAB LLC
Other - Org Name:MOUNT JOSEPH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WATERVILLE
Authorized Official - Middle Name:
Authorized Official - Last Name:REHAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-588-8811
Mailing Address - Street 1:1800 ROCKAWAY AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1678
Mailing Address - Country:US
Mailing Address - Phone:516-588-8801
Mailing Address - Fax:
Practice Address - Street 1:7 HIGHWOOD ST
Practice Address - Street 2:
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-5739
Practice Address - Country:US
Practice Address - Phone:516-588-8801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-07
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care