NPIMap

Organization Active NPI

North Country Associates, Inc

Doing business as Northland Living Center

  • Intellectual Disabilities Intermediate Care Facility
  • Jackman, ME
National Provider Identifier
1871653949
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
36354 Issued in ME
Legal business name
NORTH COUNTRY ASSOCIATES, INC
Doing business as
Northland Living Center
Practice address
382 Main St
Jackman, ME 04945-5214
Phone
(207) 668-3221
Fax
(207) 668-4159
NPI assigned
Dec 11, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Glen G Cyr
Title
VP of Finance
Phone
(207) 786-3554

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 36354 ME Primary

Addresses

Primary practice location

382 Main St
Jackman, ME 04945-5214

Mailing address

179 Lisbon St
2ND Floor
Lewiston, ME 04240-7248
Phone (207) 786-3554

Other names 1

  • Northland Living Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D0649607Northland Living Center382 Main Street, Jackman, ME 04945Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
North Country Associates Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

382 Main St
Jackman, ME 04945
Phone (207) 668-3221

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871653949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 LISBON ST",
            "address_2": "2ND FLOOR",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042407248",
            "telephone_number": "207-786-3554",
            "fax_number": "207-786-8507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 MAIN ST",
            "city": "JACKMAN",
            "state": "ME",
            "postal_code": "049455214",
            "telephone_number": "207-668-3221",
            "fax_number": "207-668-4159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH COUNTRY ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CYR",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "VP OF FINANCE",
        "authorized_official_telephone_number": "207-786-3554",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "ME",
            "license": "36354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northland Living Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jackman, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.