Pottle Hill, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

POTTLE HILL, INC.

Practice address

368 Minot Ave
Auburn, ME 04210-4331

Phone

(207) 753-1457

Fax

(207) 753-0505

NPI assigned

Nov 28, 2006

Organization subpart

No

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

Authorized official

Name

William J McCoy

Title

Executive Director

Phone

(207) 753-1457

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248134400000",
    "number": "1639245053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1537",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042111537",
            "telephone_number": "207-753-1457",
            "fax_number": "207-753-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 MINOT AVE",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042104331",
            "telephone_number": "207-753-1457",
            "fax_number": "207-753-0505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTTLE HILL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2009-07-21",
        "status": "A",
        "authorized_official_last_name": "MCCOY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "207-753-1457"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111020100",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111020101",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111020001",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111020002",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111020103",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111020000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.