Kennebec Valley Mental Health Center

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

222762 Issued in ME

Legal business name

KENNEBEC VALLEY MENTAL HEALTH CENTER

Practice address

67 Eustis Pkwy
Waterville, ME 04901-5173

Phone

(207) 873-2136

Fax

(207) 872-4522

NPI assigned

Sep 16, 2009

Organization subpart

Yes

Parent organization

KENNEBEC MENTAL HEALTH ASSOCIATESAs reported in NPPES

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

Authorized official

Name

Mr. Thomas J McAdam

Title

Ceo

Phone

(207) 873-2136

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kennebec Behavioral Health Doing business as

Locations

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253059200000",
    "number": "1740513282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 EUSTIS PKWY",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015173",
            "telephone_number": "207-873-2136",
            "fax_number": "207-872-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEBEC VALLEY MENTAL HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENNEBEC MENTAL HEALTH ASSOCIATES",
        "enumeration_date": "2009-09-16",
        "last_updated": "2009-09-16",
        "status": "A",
        "authorized_official_last_name": "MCADAM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-873-2136",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "ME",
            "license": "222762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102980002",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennebec Behavioral Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kennebec Valley Community Action Program
• Kennebec Valley Community Action Program
• Kennebec Valley Community Action Program
• Kennebec Valley Community Action Program
• Kennebec Valley Mental Health Center
• Rebecca Ellen Kennedy, LCPC-C
• Elizabeth Kristen Kennett, RN
• Robert Luther Kenney, D.O
• Kerish Benttinen LCSW, LLC
• Catherine Milliken Kimball, DO

• Mental Illness Community Based Residential Treatment Facility in Waterville, ME
• Providers in Waterville, ME by specialty
• Mental Illness Community Based Residential Treatment Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.