Park Street Home West Paris

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

License

AUS2232 Issued in ME

Legal business name

PARK STREET HOME WEST PARIS

Practice address

26 Park Street
West Paris, ME 04289-5149

Phone

(207) 674-3372

Fax

(207) 527-2645

NPI assigned

Jan 19, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Lori M Dean

Title

Adm Owner

Phone

(207) 527-2170

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073666541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 RICHARDSON HOLLOW RD",
            "city": "GREENWOOD",
            "state": "ME",
            "postal_code": "042554215",
            "telephone_number": "207-527-2100",
            "fax_number": "502-527-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 PARK STREET",
            "city": "WEST PARIS",
            "state": "ME",
            "postal_code": "042895149",
            "telephone_number": "207-674-3372",
            "fax_number": "207-527-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK STREET HOME WEST PARIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEAN",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADM OWNER",
        "authorized_official_telephone_number": "207-527-2170",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "AUS2232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Residential Treatment Facility in West Paris, ME
• Providers in West Paris, ME by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.