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KENNEBUNK
NPI 1790089753
Assisted Living Facility in Kennebunk, ME

Active since January 06, 2011CLIA 20D2055033 · Waiver
1 PENNY LN, KENNEBUNK, ME 04043(207) 985-5866 Get Directions Write a Review

NPPES record last updated: January 6, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Kennebunk NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNEBUNK (NPI 1790089753) is a healthcare organization registered as an assisted living facility in Kennebunk, Maine and active in the NPI registry since January 2011. The organization holds a CLIA Waiver certificate valid through March 4, 2027 and lists Bryan Hudson, General Counsel, as its authorized official.

NPPES Registry Identity

NPI1790089753
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameA2002 SENIOR, LLC
Location Address1 PENNY LNKennebunk, ME 04043-6635
Mailing Address1 Penny LnKennebunk, ME 04043-6635 · (207) 985-5866
Phone(207) 985-5866
Organization SubpartYes
Authorized OfficialBryan HudsonGeneral Counsel · (502) 779-7683
Enumeration DateJanuary 6, 2011
✔ NPI 1790089753 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1 PENNY LN, Kennebunk, ME 04043
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Other Names 1

Doing Business AsKennebunk

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D2055033

Kennebunk Fire Rescue · Kennebunk, ME
Active · expires Mar 4, 2027
CLIA Number20D2055033
Laboratory TypeAmbulance
Certificate Effective DateMarch 5, 2025
Certificate Expiration DateMarch 4, 2027
Laboratory DirectorBeau Gleason
Laboratory Phone(207) 604-1315
Laboratory LocationKennebunk Fire Rescue1 Summer Street, Kennebunk, ME 04043
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is A2002 Senior, LLC's NPI number?

The NPI number for A2002 Senior, LLC is 1790089753. It was assigned to this organization in the NPPES registry on January 6, 2011. The provider is doing business as Kennebunk.

Where is A2002 Senior, LLC located?

A2002 Senior, LLC is located at 1 Penny Ln, Kennebunk, ME 04043. The listed phone number is (207) 985-5866.

What is A2002 Senior, LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does A2002 Senior, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D2055033) is associated with this NPI, valid through March 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for A2002 Senior, LLC was last updated on January 6, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.