Provider Demographics
NPI:1144453960
Name:BIRCH BAY RETIREMENT VILLAGE
Entity type:Organization
Organization Name:BIRCH BAY RETIREMENT VILLAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT-OTTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-288-8014
Mailing Address - Street 1:25 VILLAGE INN ROAD
Mailing Address - Street 2:
Mailing Address - City:BAR HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04609-7451
Mailing Address - Country:US
Mailing Address - Phone:207-288-8014
Mailing Address - Fax:207-288-8652
Practice Address - Street 1:25 VILLAGE INN ROAD
Practice Address - Street 2:
Practice Address - City:BAR HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04609-7451
Practice Address - Country:US
Practice Address - Phone:207-288-8014
Practice Address - Fax:207-288-8652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility