Wide Behavior Services LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

WIDE BEHAVIOR SERVICES LLC

Doing business as

WIDE BEHAVIOR SERVICES LLC

Practice address

4 Apple Tree LN
Saco, ME 04072-8830

Phone

(207) 632-5106

NPI assigned

May 13, 2024

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Shumbusho

Title

Ceo

Phone

(207) 632-5106

Specialties & licenses 4

Addresses

Other names 1

• WIDE BEHAVIOR SERVICES LLC Doing business as

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

{
    "created_epoch": "1715558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715558400000",
    "number": "1760231864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 APPLE TREE LN",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040728830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 APPLE TREE LN",
            "city": "SACO",
            "state": "ME",
            "postal_code": "040728830",
            "telephone_number": "207-632-5106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIDE BEHAVIOR SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-13",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-13",
        "status": "A",
        "authorized_official_last_name": "SHUMBUSHO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-632-5106",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA0005X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Family Planning Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WIDE BEHAVIOR SERVICES LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Westfield Rescare LLC
• Ashley N Weymouth, LCSW
• Chelsea Grace Wheeler, M.S., CCC-SLP
• Eric H Whinrod, LMSW-CC
• Suzanne Linda White
• Paige E Wilder, APRN, FNP-C
• Susan L Wiley, LMSW-CC
• Cameron Willette, PT
• Christine E Williams, LMSW
• Carolyn Wills-Barberi, LCSW

• Mental Health Clinic/Center (Including Community Mental Health Center) in Saco, ME
• Providers in Saco, ME by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2024; 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.