Peace House Maine LLC

Primary specialty

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

Legal business name

PEACE HOUSE MAINE LLC

Practice address

6 Woodland Rd
Raymond, ME 04071-6368

Phone

(207) 409-5015

NPI assigned

Jun 22, 2020

Last updated

Jun 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Thierry Ndabahagamye, DSP

Title

Ceo

Phone

(207) 409-5015

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

Peace House Maine LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Peace House Maine LLC

  • In Home Supportive Care Agency
  • Raymond, ME
  • NPI 1053802983
  NPD tax ID

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

{
    "created_epoch": "1592784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1710503107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WOODLAND RD",
            "city": "RAYMOND",
            "state": "ME",
            "postal_code": "040716368",
            "telephone_number": "207-409-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 WOODLAND RD",
            "city": "RAYMOND",
            "state": "ME",
            "postal_code": "040716368",
            "telephone_number": "207-409-5015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE HOUSE MAINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-22",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "NDABAHAGAMYE",
        "authorized_official_first_name": "THIERRY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-409-5015",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DSP"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Raymond",
            "affiliation": "N",
            "address_1": "6 Woodland Rd",
            "city": "Raymond",
            "state": "ME",
            "country_code": "US",
            "postal_code": "040716368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patrick Kifokie Mulonda
• Carol J Nappi, RN
• New Hope Healthcare Services, LLC
• Erica Theresa Lynn Osborne
• Peace House Maine LLC
• Perpetually Becoming Therapy & Wellness
• Mary Picavet
• Sally Plummer, M.A., CCC-SLP
• Abigail Leigh Pullis, FNP-C
• Kate Radlinski, FNP, PMHNP

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Raymond, ME
• Providers in Raymond, ME by specialty
• 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 Jun 22, 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.

Verify at the official NPI Registry.