Organization Active NPI

Amicus

  • Developmentally Disabled Services Day Training Agency
  • Bangor, ME
National Provider Identifier
1124160171
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
License
431573400 Issued in ME
Legal business name
AMICUS
Practice address
96 13TH St
Bangor, ME 04401-4538
Phone
(207) 941-2892
Fax
(207) 941-2888
NPI assigned
Feb 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Authorized official

Name
Ms. Heidi R Godsoe
Title
Executive Director
Phone
(207) 941-2892

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X 431573400 ME Primary

Addresses

Primary practice location

96 13TH St
Bangor, ME 04401-4538

Mailing address

96 Thirteenth Street
Bangor, ME 04401
Phone (207) 941-2892

Other identifiers 1

IdentifierTypeStateIssuer
E55026OtherMESALES TAX EXEMPTION

National Provider Directory

National Provider Directory
Tax ID family
Amicus2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

68 Hillside Ave
Ste 1
Bangor, ME 04401

68 Hillside Ave
Ste 2
Bangor, ME 04401

96 13th St
Ste 1
Bangor, ME 04401

96 13th St
Bangor, ME 04401
Phone (207) 941-2892

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1124160171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 THIRTEENTH STREET",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "04401",
            "telephone_number": "207-941-2892",
            "fax_number": "207-941-2888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 13TH ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014538",
            "telephone_number": "207-941-2892",
            "fax_number": "207-941-2888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMICUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-13",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "GODSOE",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "207-941-2892",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "ME",
            "license": "431573400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SALES TAX EXEMPTION",
            "identifier": "E55026",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; 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.