St. John Valley Foster Home

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

ST. JOHN VALLEY FOSTER HOME

Practice address

122 Church Street
Van Buren, ME 04785-1446

Phone

(207) 868-2243

NPI assigned

Mar 20, 2009

Organization subpart

No

Name

Mrs. Sharon L Gagnon

Title

Foster Home Operator

Phone

(207) 868-2243

• Sharon L. Gagnon Other name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Mar 20, 2009.

{
    "created_epoch": "1237507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237507200000",
    "number": "1508007592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 CHURCH STREET",
            "city": "VAN BUREN",
            "state": "ME",
            "postal_code": "047851446",
            "telephone_number": "207-868-2243",
            "fax_number": "207-868-2243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 CHURCH STREET",
            "city": "VAN BUREN",
            "state": "ME",
            "postal_code": "047851446",
            "telephone_number": "207-868-2243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN VALLEY FOSTER HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-20",
        "last_updated": "2009-03-20",
        "status": "A",
        "authorized_official_last_name": "GAGNON",
        "authorized_official_first_name": "SHARON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "FOSTER HOME OPERATOR",
        "authorized_official_telephone_number": "207-868-2243",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200130000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sharon L. Gagnon",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rite Aid of Maine Inc
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• Soucy'S Foster Home
• St Remie'S Foster Home
• Tammy'S Foster Home
• Town of Van Buren
• Van Buren Ambulance Service
• Brian J Violette, L.M.T., C.F.T.
• Walgreen Co

• All providers in Van Buren, ME
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.