NPIMap

Organization Active NPI

Siesta Haven

  • Adult Care Home Facility
  • Bangor, ME
National Provider Identifier
1447486808
Registry record updated May 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
ALLA 3411 Issued in ME
Legal business name
SIESTA HAVEN
Practice address
340 State St
Bangor, ME 04401-5531
Phone
(207) 944-6328
Fax
(207) 942-1204
NPI assigned
May 29, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2009

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

Authorized official

Name
Wendy C Lainez
Title
Owner/Administrator
Phone
(207) 944-6328

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X ALLA 3411 ME Primary

Addresses

Primary practice location

340 State St
Bangor, ME 04401-5531

Mailing address

PO Box 3715
Brewer, ME 04412-3715
Phone (207) 944-6328

National Provider Directory

National Provider Directory
Tax ID family
Siesta Haven2 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.

NPI Registry JSON

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

{
    "created_epoch": "1243555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243555200000",
    "number": "1447486808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3715",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044123715",
            "telephone_number": "207-944-6328",
            "fax_number": "207-942-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015531",
            "telephone_number": "207-944-6328",
            "fax_number": "207-942-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIESTA HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-29",
        "last_updated": "2009-05-29",
        "status": "A",
        "authorized_official_last_name": "LAINEZ",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "207-944-6328"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "ME",
            "license": "ALLA 3411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.