68 Devonshire Street

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

2011 Issued in ME

Legal business name

68 DEVONSHIRE STREET

Doing business as

Portland Center for Assisted Living

Practice address

68 Devonshire St
Portland, ME 04103-4431

Phone

(207) 772-2893

NPI assigned

May 19, 2009

Organization subpart

No

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

Authorized official

Name

Wanda Pelkey

Title

Cfo

Phone

(207) 874-2700

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Portland Center for Assisted Living Doing business as

Locations

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1427283514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 DEVONSHIRE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034431",
            "telephone_number": "207-772-2893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 DEVONSHIRE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041034431",
            "telephone_number": "207-772-2893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "68 DEVONSHIRE STREET",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "PELKEY",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "207-874-2700"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "ME",
            "license": "2011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131950001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portland Center for Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirsten (Coulter) Lewis
• 1330 Dental Associates
• 207 Periodontics, PLLC
• 42 North Dental Care PLLC
• 42 North Dental Care, PLLC
• 68 Devonshire Street Corp.
• A Better Way Chiropractic
• A Simple Therapy LLC
• A Special Place, Inc.
• Lydia Abair, AGPCNP

• Alzheimer Center (Dementia Center) in Portland, ME
• Providers in Portland, 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 May 19, 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.