Spruce Run Association

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

SPRUCE RUN ASSOCIATION

Practice address

77 Essex St
Bangor, ME 04401-5301

Phone

(207) 945-5102

Fax

(207) 990-4252

NPI assigned

Apr 26, 2009

Organization subpart

No

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

Authorized official

Name

Ms. Dorathy Martel

Title

Grants Coordinator

Phone

(207) 945-5102

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Spruce Run - TH Program2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Spruce Run - TH Program

  • Case Management Agency
  • Bangor, ME
  • NPI 1619114634
  NPD tax ID

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

{
    "created_epoch": "1240704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240704000000",
    "number": "1427292192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 653",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044020653",
            "telephone_number": "207-945-5102",
            "fax_number": "207-990-4252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 ESSEX ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015301",
            "telephone_number": "207-945-5102",
            "fax_number": "207-990-4252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPRUCE RUN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-26",
        "last_updated": "2009-04-26",
        "status": "A",
        "authorized_official_last_name": "MARTEL",
        "authorized_official_first_name": "DORATHY",
        "authorized_official_title_or_position": "GRANTS COORDINATOR",
        "authorized_official_telephone_number": "207-945-5102",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432212700",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin K Sprague, LCPC
• Constance M Springer-Tracy, FNP
• Katherine Sproul, PMHNP
• Sprout & Soar Therapy LLC
• Spruce Run - TH Program
• Cheryl Marie St Louis, RN
• Katrina St Louis
• Danielle Marie St Onge, PA-C
• Sandra E St. Germain, NP
• Jocelyn Leonard St. Jean, AGACNP-BC

• Case Management Agency in Bangor, ME
• Providers in Bangor, ME by specialty
• Case Management Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.