St . Andre'S Home, Inc.
Organization Active NPI Mental Illness Community Based Residential Treatment Facility · Biddeford, ME
NPI 1104060045 · NPPES record last updated Apr 22, 2009
Key facts
- NPI
- 1104060045
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Illness Community Based Residential Treatment Facility 320800000X
- License
- 214603,429481,216796 (ME)
- Legal business name
- ST . ANDRE'S HOME, INC.
- Practice address
- 283 Elm St
Biddeford, ME 04005-3027 - Phone
- (207) 282-3351
- Fax
- (207) 282-8733
- NPI assigned
- Apr 22, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Peter Fitzpatrick
- Title
- Executive Director
- Phone
- (207) 282-3351
Practitioners 8
-
Leah C Day, LMSWCC
-
Katherine E Endy, LCSW
-
Jessica L Hopkins, LCSW
-
Naomi Kordak, LMSW
-
Jamie B. Leavitt, LCSW
-
Tara McDonald, LMSW-CC
-
Amy Marie Morin, LMSW-CC
-
Jane M Vachon, LCSW
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | 218677 | ME | |
| Mental Illness Community Based Residential Treatment Facility | 320800000X | 214603,429481,216796 | ME | Yes |
Addresses
Primary practice location
283 Elm St
Biddeford, ME 04005-3027
Mailing address
283 Elm St
Biddeford, ME 04005-3027
Phone (207) 282-3351
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 168230100 | Other | ME | OUTREACH COMMUNITY SERVICES |
| 16823000 | Medicaid | ME |
NPI Registry JSON
{
"created_epoch": "1240358400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1240358400000",
"number": "1104060045",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "283 ELM ST",
"city": "BIDDEFORD",
"state": "ME",
"postal_code": "040053027",
"telephone_number": "207-282-3351",
"fax_number": "207-282-8733"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "283 ELM ST",
"city": "BIDDEFORD",
"state": "ME",
"postal_code": "040053027",
"telephone_number": "207-282-3351",
"fax_number": "207-282-8733"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ST . ANDRE'S HOME, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-04-22",
"last_updated": "2009-04-22",
"status": "A",
"authorized_official_last_name": "FITZPATRICK",
"authorized_official_first_name": "PETER",
"authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
"authorized_official_telephone_number": "207-282-3351",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": "ME",
"license": "218677",
"primary": false
},
{
"code": "320800000X",
"taxonomy_group": "",
"desc": "Community Based Residential Treatment Facility, Mental Illness",
"state": "ME",
"license": "214603,429481,216796",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OUTREACH COMMUNITY SERVICES",
"identifier": "168230100",
"state": "ME"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "16823000",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Biddeford, ME
- Karen Tiffany Speel
- Serena Amaru Speight
- Suzanne Marie Sprague
- Spurwink Services Inc.
- George Noel Squires
- St Andre Home Inc.
- Nicole St Louis
- St. Andre Health Care Facility
- Jacqueline Stagg
- Shannon Stanhope
All providers in Biddeford, ME · Mental Illness Community Based Residential Treatment Facility in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 22, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.