Fairmount Boarding Home

Primary specialty

Custodial Care FacilityTaxonomy code 311Z00000X

License

ALLS 3363 Issued in ME

Legal business name

FAIRMOUNT BOARDING HOME

Practice address

8 13TH St
Bangor, ME 04401-4538

Phone

(207) 942-5816

Fax

(207) 942-2701

NPI assigned

Apr 24, 2009

Organization subpart

Yes

Parent organization

RAYMOND H BISHOPAs reported in NPPES

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

Authorized official

Name

Raymond H Bishop

Title

Owner

Phone

(207) 924-6211

Specialties & licenses 1

Addresses

Other identifiers 1

Tax ID family

Dexter Boarding Home2 organizations share this tax ID, including this one

Part of

Dexter Boarding Home

Other organizations with this tax ID 1

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

• Dexter Boarding Home

  • Custodial Care Facility
  • Dexter, ME
  • NPI 1205070919
  NPD tax ID

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240790400000",
    "number": "1477797181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 13TH ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014538",
            "telephone_number": "207-942-5816",
            "fax_number": "207-942-2701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 13TH ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044014538",
            "telephone_number": "207-942-5816",
            "fax_number": "207-942-2701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRMOUNT BOARDING HOME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RAYMOND H BISHOP",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-27",
        "status": "A",
        "authorized_official_last_name": "BISHOP",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-924-6211"
    },
    "taxonomies": [
        {
            "code": "311Z00000X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility",
            "state": "ME",
            "license": "ALLS 3363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103580001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eyemart Express LTD
• Frederick Inglis Rudolf Eyerer, MD
• George Eyerer, M.D.
• Cosmina I Fachiol, MD
• Donald E. Factor, M.D.
• Hanna Christine Falkie, LMSW-CC
• Families and Children Together
• Families and Children Together
• Families United
• Family Enterprises

• Custodial Care Facility in Bangor, ME
• Providers in Bangor, ME by specialty
• Custodial Care Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 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.