Magnolia Jed Prouty
Organization Active NPI Assisted Living Facility · Bucksport, ME
NPI 1376356311 · NPPES record last updated Jan 31, 2025
Key facts
- NPI
- 1376356311
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Assisted Living Facility 310400000X
- Legal business name
- MAGNOLIA JED PROUTY
- Practice address
- 57 Main St
Bucksport, ME 04416-4115 - Phone
- (207) 902-1220
- Fax
- (207) 902-1230
- NPI assigned
- Jan 31, 2025
- Organization subpart
- No
Authorized official
- Name
- Taylor Morris
- Title
- Ceo
- Phone
- (207) 702-0144
Practitioners 1
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Yes |
Addresses
Primary practice location
57 Main St
Bucksport, ME 04416-4115
Mailing address
175 Exchange St Ste 240
Bangor, ME 04401-7408
Other names
- Evergreen Assisted Living, LLC
Other providers in Bucksport, ME
- Anna Levesque
- Beth Ann Lieberman
- Megan Light
- Erin Melton Lohr
- Laura Macrae
- Mainestay Counseling, LLC
- Erin Nicole Metcalf
- Tonya Larsen Murray
- Orland School Department
- Sylvester A Osa-Iyare
All providers in Bucksport, ME · Assisted Living Facility in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 31, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.