NPIMap

Organization Active NPI

Woodlands Senior Living of Farmington, LLC

  • Assisted Living Facility
  • Farmington, ME
National Provider Identifier
1235628934
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
PENDING Issued in ME
Legal business name
WOODLANDS SENIOR LIVING OF FARMINGTON, LLC
Doing business as
Woodlands Assisted Living of Farmington
Practice address
175 Knowlton Corner Rd
Farmington, ME 04938-6200
Phone
(207) 872-8992
Fax
(207) 861-7072
NPI assigned
May 8, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Mr. Matthew Walters
Title
Chief Operating Officer
Phone
(207) 872-8992

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X PENDING ME Primary

Addresses

Primary practice location

175 Knowlton Corner Rd
Farmington, ME 04938-6200

Mailing address

175 Knowlton Corner Rd
Farmington, ME 04938-6200
Phone (207) 872-8992

Other names 1

  • Woodlands Assisted Living of Farmington Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D2150958Woodlands Assisted Living of Farmington175 Knowlton Corner Road, Farmington, ME 04938Certificate of waiverJul 8, 2028

National Provider Directory

National Provider Directory
Tax ID family
Park Residences of Farmington3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1525737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1235628934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 KNOWLTON CORNER RD",
            "city": "FARMINGTON",
            "state": "ME",
            "postal_code": "049386200",
            "telephone_number": "207-872-8992",
            "fax_number": "207-861-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 KNOWLTON CORNER RD",
            "city": "FARMINGTON",
            "state": "ME",
            "postal_code": "049386200",
            "telephone_number": "207-872-8992",
            "fax_number": "207-861-7072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLANDS SENIOR LIVING OF FARMINGTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-08",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "WALTERS",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "207-872-8992",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "ME",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodlands Assisted Living of Farmington",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Woodlands Assisted Living of Farmington",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Farmington, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.