NPIMap

Organization Active NPI

Grace Street Services LLC

  • Community/Behavioral Health Agency
  • Lewiston, ME
National Provider Identifier
1639483233
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
605962 Issued in ME
Legal business name
GRACE STREET SERVICES LLC
Practice address
105 Middle St
Lewiston, ME 04240-7037
Phone
(207) 212-9258
NPI assigned
Aug 6, 2010
Last updated
Aug 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Authorized official

Name
Martin Joseph Obrien Sr., LADCNPI 1013224484
Title
Director
Phone
(207) 212-9258

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 605962 ME Primary
Community/Behavioral Health Agency 251S00000X 606205 ME

Addresses

Primary practice location

105 Middle St
Lewiston, ME 04240-7037

Mailing address

105 Middle St
Lewiston, ME 04240-7037
Phone (207) 212-9258

National Provider Directory

National Provider Directory
Tax ID family
Grace Street Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1639483233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 MIDDLE ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407037",
            "telephone_number": "207-212-9258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MIDDLE ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407037",
            "telephone_number": "207-212-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE STREET SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "OBRIEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "207-212-9258",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "LADC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "605962",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "ME",
            "license": "606205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewiston, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2010; 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.