Organization Active NPI

Southern Maine Agency on Aging

  • Adult Day Care Clinic/Center
  • Biddeford, ME
National Provider Identifier
1174759500
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
License
ALLS3017 Issued in ME
Legal business name
SOUTHERN MAINE AGENCY ON AGING
Doing business as
The Sam L. Cohen Center
Practice address
30 Barra Rd
Biddeford, ME 04005-9459
Phone
(207) 283-0166
Fax
(207) 283-2470
NPI assigned
May 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Authorized official

Name
Laurie Riedel
Title
Cfo
Phone
(207) 396-6500

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Adult Day Care Clinic/Center 261QA0600X ALLS3017 ME Primary

Addresses

Primary practice location

30 Barra Rd
Biddeford, ME 04005-9459

Mailing address

30 Barra Rd
Biddeford, ME 04005-9459
Phone (207) 396-6500

Other identifiers 1

IdentifierTypeStateIssuer
109570000MedicaidME

Other names 1

  • The Sam L. Cohen Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Southern Maine Agency on Aging2 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

30 Barra Rd
Biddeford, ME 04005
Phone (207) 283-0166

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745971200000",
    "number": "1174759500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BARRA RD",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059459",
            "telephone_number": "207-396-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 BARRA RD",
            "city": "BIDDEFORD",
            "state": "ME",
            "postal_code": "040059459",
            "telephone_number": "207-283-0166",
            "fax_number": "207-283-2470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MAINE AGENCY ON AGING",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-29",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "RIEDEL",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "207-396-6500"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "ME",
            "license": "ALLS3017",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "109570000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Sam L. Cohen Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Biddeford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2025; 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.