Active NPI
Freeport Convelsant Center
Doing business as Hawthorne House
- Assisted Living Facility
- Freeport, ME
National Provider Identifier
1982839072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- 2005
- Legal business name
- FREEPORT CONVELSANT CENTER
- Doing business as
- Hawthorne House
- Practice address
- 6 Old County Rd
Freeport, ME 04032-6231 - Phone
- (207) 865-4782
- NPI assigned
- May 19, 2009
- Last updated
- May 19, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wanda Pelkey
- Title
- Cfo
- Phone
- (207) 874-2700
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | 2005 | ME | Primary |
Addresses
Primary practice location
6 Old County Rd
Freeport, ME 04032-6231
Mailing address
6 Old County Rd
Freeport, ME 04032-6231
Phone (207) 865-4782
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 120030001 | Medicaid | ME |
Other names 1
- Hawthorne House
National Provider Directory
National Provider Directory- Tax ID family
- Freeport Convalescent Center Inc
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Hawthorne House
- Skilled Nursing Facility
- Freeport, ME
- NPI 1427026657
-
dba Hawthorne House
- Mental Illness Intermediate Care Facility
- Freeport, ME
- NPI 1871728964
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242691200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1242691200000",
"number": "1982839072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 OLD COUNTY RD",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040326231",
"telephone_number": "207-865-4782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6 OLD COUNTY RD",
"city": "FREEPORT",
"state": "ME",
"postal_code": "040326231",
"telephone_number": "207-865-4782"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FREEPORT CONVELSANT CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2009-05-19",
"last_updated": "2009-05-19",
"status": "A",
"authorized_official_last_name": "PELKEY",
"authorized_official_first_name": "WANDA",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "207-874-2700"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "ME",
"license": "2005",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "120030001",
"state": "ME"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hawthorne House",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Freeport, ME
- Julie Fournier, LMSW-CC
- Justine Nicole Fraser
- Freeport Cardiology, LLC
- Freeport Convalescent Center Inc (Hawthorne House)
- Freeport Convalscent Center (Hawthorne House)
- Freeport Dental Associates, P.C.
- Freeport Integrated Health Center, P.a.
- Freeport Medical Center PA
- Freeport Nursing Home, Inc
- Freeport Physical Therapy, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.