Woodlands Senior Living of Brewer, LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

ALLS2646 Issued in ME

Legal business name

WOODLANDS SENIOR LIVING OF BREWER, LLC

Doing business as

Woodlands Memory Care of Brewer

Practice address

53 Colonial Cir
Brewer, ME 04412-1448

Phone

(207) 989-7577

Fax

(207) 989-0577

NPI assigned

May 1, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Jill A Sirois, R.N.

Title

Director of Professional Services

Phone

(207) 872-8992

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Woodlands Memory Care of Brewer Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Woodlands Assisted Living of Brewer2 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.

• Woodlands Senior Living of Brewer, LLC

  dba Woodlands Assisted Living of Brewer

  • Assisted Living Facility
  • Brewer, ME
  • NPI 1518939172
  NPD tax ID

Practitioners 2

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

• Teresa M Bartlett, FNP

  • Family Nurse Practitioner
  • Bangor, ME
  • NPI 1386980829
  NPD (past)
• Ethan S Caron, PAC

  • Physician Assistant
  • Bangor, ME
  • NPI 1932763331
  NPD (past)

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435017600000",
    "number": "1861613879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 W RIVER RD",
            "address_2": "SUITE 300",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049015098",
            "telephone_number": "207-872-8992",
            "fax_number": "207-861-7072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53 COLONIAL CIR",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121448",
            "telephone_number": "207-989-7577",
            "fax_number": "207-989-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOODLANDS SENIOR LIVING OF BREWER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-01",
        "last_updated": "2015-06-23",
        "status": "A",
        "authorized_official_last_name": "SIROIS",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DIRECTOR OF PROFESSIONAL SERVICES",
        "authorized_official_telephone_number": "207-872-8992",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "ME",
            "license": "ALLS2646",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LEVEL IV PNMI RCF LICENSE",
            "identifier": "ALLS2646",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodlands Memory Care of Brewer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abbie Leigh Wickett, LCPC
• William Eugene Wiggin, LCSW
• Jaime Nicole Williams, FNP-C
• Joni L Winkler, FNPC, PMHNP
• Woodlands Senior Living of Brewer, LLC (Woodlands Assisted Living of Brewer)
• Alexander Hoi Ki Wu
• Dina Yacoubagha
• Jennifer Ann Young, CADC
• Nicole Young, CADC

• Alzheimer Center (Dementia Center) in Brewer, ME
• Providers in Brewer, ME by specialty
• Alzheimer Center (Dementia Center) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.