Active NPI
Mainehealth
Doing business as Safe Havens at St. Andrews Village
- Alzheimer Center (Dementia Center)
- Boothbay Harbor, ME
National Provider Identifier
1669569133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Alzheimer Center (Dementia Center)
- License
- 2019
- Legal business name
- MAINEHEALTH
- Doing business as
- Safe Havens at St. Andrews Village
- Practice address
- 145 Emery Lane
Boothbay Harbor, ME 04538 - Phone
- (207) 633-0920
- Fax
- (207) 633-1211
- NPI assigned
- Oct 6, 2006
- Last updated
- Sep 8, 2020
- Organization subpart
- Yes
- Parent organization
- MAINEHEALTH
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wayne Printy
- Title
- Cfo
- Phone
- (207) 563-4476
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Alzheimer Center (Dementia Center) | 311500000X | 2019 | ME | Primary |
Addresses
Primary practice location
145 Emery Lane
Boothbay Harbor, ME 04538
Mailing address
145 Emery Lane
Boothbay Harbor, ME 04538
Phone (207) 633-0920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 101560401 | Medicaid | ME |
Other names 1
- Safe Havens at St. Andrews Village
National Provider Directory
National Provider Directory- Tax ID family
- Maine Medical Assoc
- Part of
- Maine Medical Assoc
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
dba MaineHealth Maine Medical Center
- General Acute Care Hospital
- Portland, ME
- NPI 1508897059
-
dba Maine Medical Partners Specialty Care
- General Acute Care Hospital
- Portland, ME
- NPI 1518342526
-
dba Spring Harbor Community Services
- Community/Behavioral Health Agency
- Rockland, ME
- NPI 1518447325
-
dba Gregory Wing at St. Andrews Village
- Nursing Facility/Intermediate Care Facility
- Boothbay Harbor, ME
- NPI 1528151065
-
dba MaineHealth Pen Bay Hospital
- Medicare Defined Swing Bed Hospital Unit
- Rockport, ME
- NPI 1568273241
-
dba MaineHealth Behavioral Health at Spring Harbor
- Psychiatric Hospital
- Westbrook, ME
- NPI 1598798787
-
dba MaineHealth MT Blue Health Center
- Rural Health Clinic/Center
- Farmington, ME
- NPI 1619510047
-
dba SMHC Walk In Care-Waterboro
- Urgent Care Clinic/Center
- East Waterboro, ME
- NPI 1649750449
-
dba Kenneth Ault MD
- Hematology (Internal Medicine) Physician
- Scarborough, ME
- NPI 1659475036
-
dba MaineHealth Primary Care Internal Medicine
- General Acute Care Hospital
- Topsham, ME
- NPI 1669300406
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160092800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1599523200000",
"number": "1669569133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 EMERY LANE",
"city": "BOOTHBAY HARBOR",
"state": "ME",
"postal_code": "04538",
"telephone_number": "207-633-0920",
"fax_number": "207-633-1211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 EMERY LANE",
"city": "BOOTHBAY HARBOR",
"state": "ME",
"postal_code": "04538",
"telephone_number": "207-633-0920",
"fax_number": "207-633-1211"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAINEHEALTH",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "MAINEHEALTH",
"enumeration_date": "2006-10-06",
"last_updated": "2020-09-08",
"certification_date": "2020-09-08",
"status": "A",
"authorized_official_last_name": "PRINTY",
"authorized_official_first_name": "WAYNE",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "207-563-4476"
},
"taxonomies": [
{
"code": "311500000X",
"taxonomy_group": "",
"desc": "Alzheimer Center (Dementia Center)",
"state": "ME",
"license": "2019",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101560401",
"state": "ME"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Safe Havens at St. Andrews Village",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "Safe Havens at St. Andrews Village",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Boothbay Harbor, ME
- Lincolnhealth (St. Andrews Family Care Center RHC)
- Wiley B Macleod, MOTR/L
- Mainehealth (Assisted Living at St. Andrews Village)
- Mainehealth (Safe Haven at St. Andrews Village)
- Mainehealth (Gregory Wing at St. Andrews Village)
- Mainehealth (Gregory Wing at St. Andrews Village)
- Mainehealth (MaineHealth John F Andrews Health Center)
- Shane Taylor McNear
- Mid-Coast Spine & Sport LLC
- Miles Memorial Hospital (MMG Pediatrics-Boothbay A Department of Miles Memorial Hospital)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.