Basic Information
| Provider Information | |||||||||
| NPI: | 1386707826 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CAMDEN OPERATIONS, LLC | ||||||||
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| OtherOrganizationName: | WINDWARD GARDENS | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | KENNETT SQUARE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193483109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6109254436 | ||||||||
| FaxNumber: | 6109254351 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 MECHANIC ST | ||||||||
| Address2: | |||||||||
| City: | CAMDEN | ||||||||
| State: | ME | ||||||||
| PostalCode: | 048431811 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2072364197 | ||||||||
| FaxNumber: | 2072800563 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/18/2006 | ||||||||
| LastUpdateDate: | 11/16/2011 | ||||||||
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| AuthorizedOfficialLastName: | DROPESKEY | ||||||||
| AuthorizedOfficialFirstName: | JANE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CORPORATE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 6109254231 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | 1984 | ME | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
ID Information
| ID | Type | State | Issuer | Description | 432470501 | 05 | ME | MEDICAID |