Kre Husky Yarmouth Licensee LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

KRE HUSKY YARMOUTH LICENSEE LLC

Doing business as

Bay Square at Yarmouth

Practice address

27 Forest Falls Dr
Yarmouth, ME 04096-6972

Phone

(206) 447-9075

NPI assigned

Jun 11, 2025

Last updated

Jun 11, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thomas Grape

Title

President

Phone

(781) 489-7100

Specialties & licenses 1

Addresses

Other names 1

• Bay Square at Yarmouth Doing business as

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

{
    "created_epoch": "1749600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1396630075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 JONES RD STE 300",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511618",
            "telephone_number": "781-489-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 FOREST FALLS DR",
            "city": "YARMOUTH",
            "state": "ME",
            "postal_code": "040966972",
            "telephone_number": "206-447-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRE HUSKY YARMOUTH LICENSEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-11",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "GRAPE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-489-7100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bay Square at Yarmouth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility (Mental Illness) in Yarmouth, ME
• Providers in Yarmouth, ME by specialty
• Assisted Living Facility (Mental Illness) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.