NPIMap

Organization Active NPI

Charlotte White Center

  • Mental Illness Community Based Residential Treatment Facility
  • Dover Foxcroft, ME
National Provider Identifier
1154497030
Registry record updated Nov 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
CHARLOTTE WHITE CENTER
Practice address
9 Paul St
Dover Foxcroft, ME 04426-1050
Phone
(207) 564-2464
Fax
(207) 564-2404
NPI assigned
Nov 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2008

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

Authorized official

Name
Mr. Richard M Brown
Title
Ceo
Phone
(207) 564-2464

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

9 Paul St
Dover Foxcroft, ME 04426-1050

Mailing address

572 Bangor Rd
Dover Foxcroft, ME 04426-3373
Phone (207) 564-2464

Other identifiers 1

IdentifierTypeStateIssuer
164850001MedicaidME

Other names 1

  • Starks House Other name

National Provider Directory

National Provider Directory
Tax ID family
Charlotte White Center10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1154497030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 BANGOR RD",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044263373",
            "telephone_number": "207-564-2464",
            "fax_number": "207-564-2404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PAUL ST",
            "city": "DOVER FOXCROFT",
            "state": "ME",
            "postal_code": "044261050",
            "telephone_number": "207-564-2464",
            "fax_number": "207-564-2404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLOTTE WHITE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-564-2464",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164850001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Starks House",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Dover Foxcroft, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; 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.