NPIMap

Organization Active NPI

Ross Manor Associates

  • Alzheimer Center (Dementia Center)
  • Bangor, ME
National Provider Identifier
1790910883
Registry record updated May 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Alzheimer Center (Dementia Center)Taxonomy code 311500000X
License
1988 Issued in ME
Legal business name
ROSS MANOR ASSOCIATES
Doing business as
Ross Manor
Practice address
758 Broadway
Bangor, ME 04401-3224
Phone
(207) 941-8400
Fax
(207) 974-1135
NPI assigned
May 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2009

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

Authorized official

Name
Wanda Pelkey
Title
Cfo
Phone
(207) 874-2700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Alzheimer Center (Dementia Center) 311500000X 1988 ME Primary

Addresses

Primary practice location

758 Broadway
Bangor, ME 04401-3224

Mailing address

758 Broadway
Bangor, ME 04401-3224
Phone (207) 941-8400

Other identifiers 1

IdentifierTypeStateIssuer
120640001MedicaidME

Other names 1

  • Ross Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ross Manor2 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.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242691200000",
    "number": "1790910883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "758 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013224",
            "telephone_number": "207-941-8400",
            "fax_number": "207-974-1135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "758 BROADWAY",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044013224",
            "telephone_number": "207-941-8400",
            "fax_number": "207-974-1135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSS MANOR ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-19",
        "last_updated": "2009-05-19",
        "status": "A",
        "authorized_official_last_name": "PELKEY",
        "authorized_official_first_name": "WANDA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "207-874-2700"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "ME",
            "license": "1988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "120640001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ross Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 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.