Organization Active NPI

Community Living Association

Nursing Care Agency
Houlton, ME

National Provider Identifier

1144274564

Registry record updated Jun 10, 2010

On this page

Key facts
NPPES NPI Registry
National Provider Directory
Practitioners & affiliated clinicians
NPI Registry JSON
Other providers in Houlton, ME
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Nursing Care AgencyTaxonomy code 251J00000X
License: 36274 Issued in ME
Legal business name: COMMUNITY LIVING ASSOCIATION
Practice address: 45 School St
Houlton, ME 04730-2010
Phone: (207) 532-9446
Fax: (207) 532-1359
NPI assigned: May 20, 2006
Last updated: Jun 10, 2010By the provider in NPPES
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Jun 10, 2010

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

Authorized official

Name: Mr. Shannon Jon Hogan
Title: Finance Manager
Phone: (207) 532-9446

Specialties & licenses 10

Specialty (taxonomy)	Code	License	State	Primary
Nursing Care Agency	251J00000X	36274	ME	Primary
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	36310	ME
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	ALLS2160	ME
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	ALLS2161	ME
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	ALLS1110	ME
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	ALLS2148	ME
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	ALLS2155	ME
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	ALLS2154	ME
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	ALLS2193	ME
Intellectual and/or Developmental Disabilities Residential Treatment Facility	320600000X	ALLS2147	ME

Addresses

Primary practice location

45 School St
Houlton, ME 04730-2010

Mailing address

45 School St
Houlton, ME 04730-2010
Phone (207) 532-9446

Other identifiers 15

Identifier	Type	State
104190100	Medicaid	ME
104190204	Medicaid	ME
104190208	Medicaid	ME
431576700	Medicaid	ME
104190205	Medicaid	ME
104190207	Medicaid	ME
104190209	Medicaid	ME
104190210	Medicaid	ME
104190000	Medicaid	ME
104190201	Medicaid	ME
104190202	Medicaid	ME
104190203	Medicaid	ME
104190206	Medicaid	ME
104190101	Medicaid	ME
104190200	Medicaid	ME

National Provider Directory

Locations

45 School St
Houlton, ME 04730
Phone (207) 532-9446

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Solomon Babajide Olabiyi, MD
- Internal Medicine Physician
- Houlton, ME
- NPI 1366734170
NPD (past)

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276128000000",
    "number": "1144274564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SCHOOL ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047302010",
            "telephone_number": "207-532-9446",
            "fax_number": "207-532-1359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SCHOOL ST",
            "city": "HOULTON",
            "state": "ME",
            "postal_code": "047302010",
            "telephone_number": "207-532-9446",
            "fax_number": "207-532-1359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY LIVING ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-06-10",
        "status": "A",
        "authorized_official_last_name": "HOGAN",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "FINANCE MANAGER",
        "authorized_official_telephone_number": "207-532-9446",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": "ME",
            "license": "36274",
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "36310",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS2160",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS2161",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS1110",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS2148",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS2155",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS2154",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS2193",
            "primary": false
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS2147",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190100",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190204",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190208",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "431576700",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190205",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190207",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190209",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190210",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190201",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190202",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190203",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190206",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190101",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104190200",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houlton, ME

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2010; 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.