Atlantic Community Support LLC

Primary specialty

Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X

Legal business name

ATLANTIC COMMUNITY SUPPORT LLC

Practice address

75 Bishop St Ste 13
Portland, ME 04103-2614

Phone

(207) 405-7181

NPI assigned

Oct 24, 2019

Last updated

Oct 24, 2019By 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. Kamil Aweis Suja

Title

Ceo

Phone

(207) 405-7181

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571875200000",
    "number": "1437792199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 BISHOP ST STE 13",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032614",
            "telephone_number": "207-405-7181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 BISHOP ST STE 13",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032614",
            "telephone_number": "207-405-7181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC COMMUNITY SUPPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A",
        "authorized_official_last_name": "SUJA",
        "authorized_official_first_name": "KAMIL",
        "authorized_official_middle_name": "AWEIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-405-7181",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "84-3458034",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Atienza
• Maria A Atkins, D.O.
• Amanda Atkinson-Lewis, LCSW
• Cynthia A. Atkinson, MD
• Atlantic Chiropractic Limited Liability Company
• Atlantic Foot & Ankle Center
• Atlantic Home Care, LLC
• Atlantic Home Healthcare LLC (Atlantic Home care, llc)
• Atlantic Medicine LLC
• Atlantic Prosthetic and Orthotic Services (AtlanticProCare)

• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Portland, ME
• Providers in Portland, ME by specialty
• Intellectual and/or Developmental Disabilities Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.