Manor at Phillipstown Place Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

ALLS 3199 Issued in ME

Legal business name

MANOR AT PHILLIPSTOWN PLACE INC

Practice address

27 Mayflower St
Sanford, ME 04073-3645

Phone

(207) 490-0400

NPI assigned

Apr 28, 2009

Organization subpart

Yes

Parent organization

MANOR AT PHILLIPSTOWNAs reported in NPPES

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

Authorized official

Name

Mr. Ron Bryant

Title

Chief Financial Officer

Phone

(207) 490-7327

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mayflower Place Other name

Tax ID family

Manor at Phillipstown Place Inc2 organizations share this tax ID, including this one

Part of

Manor at Phillipstown Place Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Manor at Phillipstown Place Inc

  • Custodial Care Facility
  • Springvale, ME
  • NPI 1295979755
  NPD tax ID

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240876800000",
    "number": "1104060656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 JUNE ST",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040732621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 MAYFLOWER ST",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040733645",
            "telephone_number": "207-490-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR AT PHILLIPSTOWN PLACE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MANOR AT PHILLIPSTOWN",
        "enumeration_date": "2009-04-28",
        "last_updated": "2009-04-28",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "207-490-7327",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ME",
            "license": "ALLS 3199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "124600001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mayflower Place",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Mainehealth
• Mainehealth
• Mainehealth
• Malathy T Sundaram M.D, LLC
• Malathy T. Sundaram, M. D. LLC
• Martha G. Andrews
• Mary Jane Grant Sign Language Interpreting Services, LLC
• Albert Joseph Mastraccio Jr., O.D.
• Briana McAndrew, O.D.
• Barbara P McCall, MD

• All providers in Sanford, ME
• Assisted Living Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; 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.