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Organization Active NPI

Kidspeace National Centers of New England Inc

  • Assisted Living Facility (Mental Illness)
  • Bangor, ME
National Provider Identifier
1346364445
Registry record updated Apr 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
License
322081 Issued in ME
Legal business name
KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND INC
Practice address
444 Stillwater Ave Ste 204
Bangor, ME 04401-3500
Phone
(207) 299-1414
Fax
(207) 947-6278
NPI assigned
Mar 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2009

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

Authorized official

Name
Mr. Michael W Slack
Title
VP for Marketing and Business Devel
Phone
(800) 854-3123

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X 322081 ME Primary

Addresses

Primary practice location

444 Stillwater Ave Ste 204
Bangor, ME 04401-3500

Mailing address

4085 Independence Drive
Schenecksville, PA 18078
Phone (800) 854-3123

Other identifiers 1

IdentifierTypeStateIssuer
123430109MedicaidME

National Provider Directory

National Provider Directory
Tax ID family
Kidspeace New England46 organizations share this tax ID, including this one

Other organizations with this tax ID 45

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

View all 45

Locations

49 Florida Ave
Bangor, ME 04401
Phone (207) 299-1414

49 Atlantic Pl
South Portland, ME 04106
Phone (207) 771-5700

NPI Registry JSON

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239321600000",
    "number": "1346364445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4085 INDEPENDENCE DRIVE",
            "city": "SCHENECKSVILLE",
            "state": "PA",
            "postal_code": "18078",
            "telephone_number": "800-854-3123",
            "fax_number": "610-799-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 STILLWATER AVE STE 204",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013500",
            "telephone_number": "207-299-1414",
            "fax_number": "207-947-6278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-16",
        "last_updated": "2009-04-10",
        "status": "A",
        "authorized_official_last_name": "SLACK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VP FOR MARKETING AND BUSINESS DEVEL",
        "authorized_official_telephone_number": "800-854-3123",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "ME",
            "license": "322081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123430109",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.