NPIMap

Organization Active NPI

Community Clinical Services, Inc.

Doing business as CCS Behavioral at LAIM

  • Federally Qualified Health Center (FQHC)
  • Auburn, ME
National Provider Identifier
1346695756
Registry record updated Oct 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY CLINICAL SERVICES, INC.
Doing business as
CCS Behavioral at LAIM
Practice address
3 Willow Run
Room a
Auburn, ME 04210-8501
Phone
(207) 795-6800
Fax
(207) 795-6140
NPI assigned
May 4, 2016
Last updated
Oct 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
COMMUNITY CLINICAL SERVICES, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2020

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

Authorized official

Name
Coleen L Elias
Title
Ceo/Cfo
Phone
(207) 513-3897

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

3 Willow Run
Room a
Auburn, ME 04210-8501

Mailing address

PO Box 95000 LBX 7660
Philadelphia, PA 19195-0001
Phone (207) 777-8202

Other names 1

  • CCS Behavioral at LAIM Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1346695756. Details of each certification follow.

  • CCN 201929 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 201929

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CCS BEHAVIORAL AT LAIM
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 16, 2016
Last certification
Aug 16, 2016
Ownership / control type
For profit – corporation
Facility address
3 Willow Run, Room a
Auburn, ME 04210

National Provider Directory

National Provider Directory
Tax ID family
Community Clinical Services Inc23 organizations share this tax ID, including this one
Part of
Community Clinical Services Inc

Other organizations with this tax ID 22

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

View all 22

Locations

3 Willow Run
Rm A
Auburn, ME 04210
Phone (207) 795-6800

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603324800000",
    "number": "1346695756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000 LBX 7660",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001",
            "telephone_number": "207-777-8202",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WILLOW RUN",
            "address_2": "ROOM A",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042108501",
            "telephone_number": "207-795-6800",
            "fax_number": "207-795-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CLINICAL SERVICES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMMUNITY CLINICAL SERVICES, INC.",
        "enumeration_date": "2016-05-04",
        "last_updated": "2020-10-22",
        "certification_date": "2020-10-22",
        "status": "A",
        "authorized_official_last_name": "ELIAS",
        "authorized_official_first_name": "COLEEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO/CFO",
        "authorized_official_telephone_number": "207-513-3897"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CCS Behavioral at LAIM",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CCS Behavioral at LAIM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Auburn, ME

Sources for this page

Verify at the official NPI Registry.