NPIMap

Organization Active NPI

Children'S Center: Early Intervention and Family Support, Inc.

  • Specialist
  • Augusta, ME
National Provider Identifier
1174763411
Registry record updated Feb 26, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
CHILDREN'S CENTER: EARLY INTERVENTION AND FAMILY SUPPORT, INC.
Practice address
1 Alden Ave
Augusta, ME 04330-6185
Phone
(207) 626-3497
Fax
(207) 621-6211
NPI assigned
Feb 26, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2009

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

Authorized official

Name
Mr. Jonathan H. Leach
Title
Executive Director
Phone
(207) 626-3497

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

1 Alden Ave
Augusta, ME 04330-6185

Mailing address

1 Alden Ave
Augusta, ME 04330-6185
Phone (207) 626-3497

Other identifiers 5

IdentifierTypeStateIssuer
103730200MedicaidME
103730000MedicaidME
103730400MedicaidME
103730300MedicaidME
103730100MedicaidME

National Provider Directory

National Provider Directory

Locations

1 Alden Ave
Ste 1
Augusta, ME 04330

1 Alden Ave
Augusta, ME 04330
Phone (207) 626-3497

188 Madison Ave
Skowhegan, ME 04976
Phone (207) 612-5000

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1235606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235606400000",
    "number": "1174763411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ALDEN AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306185",
            "telephone_number": "207-626-3497",
            "fax_number": "207-621-6211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ALDEN AVE",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043306185",
            "telephone_number": "207-626-3497",
            "fax_number": "207-621-6211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDREN'S CENTER: EARLY INTERVENTION AND FAMILY SUPPORT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-26",
        "last_updated": "2009-02-26",
        "status": "A",
        "authorized_official_last_name": "LEACH",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "207-626-3497",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103730200",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103730000",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103730400",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103730300",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103730100",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2009; 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.