Pine Hill Home Supports,Inc.

Primary specialty

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

License

ALLS 3061 Issued in ME

Legal business name

PINE HILL HOME SUPPORTS,INC.

Practice address

198 Pine Hill Rd
Monmouth, ME 04259-7517

Phone

(207) 933-2915

Fax

(207) 933-9122

NPI assigned

Jan 9, 2009

Last updated

Jan 9, 2009By 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

Daniel Rush

Title

Financial Manager

Phone

(207) 933-2915

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Rushes Foster Homes Other name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Elizabeth E Rush

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Monmouth, ME
  • NPI 1760518757
  NPD (past)

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

{
    "created_epoch": "1231459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231459200000",
    "number": "1790922979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 PINE HILL RD.",
            "city": "MONMOUTH",
            "state": "ME",
            "postal_code": "04259",
            "telephone_number": "207-933-2915",
            "fax_number": "207-933-9122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 PINE HILL RD",
            "city": "MONMOUTH",
            "state": "ME",
            "postal_code": "042597517",
            "telephone_number": "207-933-2915",
            "fax_number": "207-933-9122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINE HILL HOME SUPPORTS,INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-09",
        "last_updated": "2009-01-09",
        "status": "A",
        "authorized_official_last_name": "RUSH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "FINANCIAL MANAGER",
        "authorized_official_telephone_number": "207-933-2915"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS 3061",
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "ME",
            "license": "ALLS 2371",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125520001",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "125520000",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rushes Foster Homes",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Monmouth School Department
• Roberta Jacqueline Mullan, LADC
• Lynn Murphy, LCSW, CADC
• Diane Adele Nugent, RPT
• Andrew A Phinney, LCSW
• Cheryl Ramsdell
• Jilleon Roy, RD
• Elizabeth E Rush
• Jenora Sue Schultz, MPT
• Monica Lynn Shultz, COTA/L

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Monmouth, ME
• Providers in Monmouth, 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 Jan 9, 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.