Heaven Community Services LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

HEAVEN COMMUNITY SERVICES LLC

Practice address

196 Park St Apt 2R
Lewiston, ME 04240-7325

Phone

(207) 520-3741

NPI assigned

Aug 31, 2023

Organization subpart

No

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

Authorized official

Name

Mr. Geremias Mbumba Buidi Sr.

Title

Ceo

Phone

(207) 520-3741

Specialties & licenses 1

Addresses

Other names 1

• Heaven Community Services LLC Doing business as

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

{
    "created_epoch": "1693440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693440000000",
    "number": "1114703667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 PARK ST APT 2R",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407325",
            "telephone_number": "207-520-3741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 PARK ST APT 2R",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407325",
            "telephone_number": "207-520-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEAVEN COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-31",
        "last_updated": "2023-08-31",
        "certification_date": "2023-08-31",
        "status": "A",
        "authorized_official_last_name": "BUIDI",
        "authorized_official_first_name": "GEREMIAS",
        "authorized_official_middle_name": "MBUMBA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-520-3741",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heaven Community Services LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Lewiston, ME
• Providers in Lewiston, ME by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.