Woodlands Senior Living of Waterville, Inc.

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

ALLS5407 Issued in ME

Legal business name

WOODLANDS SENIOR LIVING OF WATERVILLE, INC.

Doing business as

Woodlands Memory Care of Waterville

Practice address

147 W River Rd
Waterville, ME 04901-5070

Phone

(207) 861-5685

Fax

(207) 861-5684

NPI assigned

Feb 6, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Jill A. Sirois, R.N.

Title

Professional Services Consultant

Phone

(207) 872-8992

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodlands Memory Care of Waterville Doing business as

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

CLIA laboratory certificates

Tax ID family

Park Residences3 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.

• Woodlands Senior Living of Waterville, Inc.

  • Assisted Living Facility
  • Waterville, ME
  • NPI 1346212438
  NPD tax ID
• Woodlands Senior Living of Waterville, LLC

  • Assisted Living Facility
  • Waterville, ME
  • NPI 1285606848
  NPD tax ID

Practitioners 1

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

• Susan Renee Folk, NP

  • Family Nurse Practitioner
  • Augusta, ME
  • NPI 1013343342
  NPD (past)

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1275505935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 W RIVER RD",
            "address_2": "SUITE 300",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015098",
            "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": "147 W RIVER RD",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015070",
            "telephone_number": "207-861-5685",
            "fax_number": "207-861-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLANDS SENIOR LIVING OF WATERVILLE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-06",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "SIROIS",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PROFESSIONAL SERVICES CONSULTANT",
        "authorized_official_telephone_number": "207-872-8992",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "ME",
            "license": "ALLS5407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "127550001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodlands Memory Care of Waterville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Deborah I Witkin, MD
• Steve Richard Witkin, M.D.
• Maxine Wolph-Johnson
• Robin M Wood, M.D.
• Woodlands Senior Living of Madison LLC
• Woodlands Senior Living of Waterville, Inc.
• Woodlands Senior Living of Waterville, LLC
• Jimmie J Woodlee, PA
• Kristi Marie Woods, RNC
• Gayle Wendy Workman, PTA

• Alzheimer Center (Dementia Center) in Waterville, ME
• Providers in Waterville, ME by specialty
• Alzheimer Center (Dementia Center) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; 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.