Back to Basics Behavioral Health Services, Inc.

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

License

CS1-11-963 Issued in ME

Legal business name

BACK TO BASICS BEHAVIORAL HEALTH SERVICES, INC.

Practice address

44 Depot Rd
Lebanon, ME 04027-3347

Phone

(207) 651-4295

Fax

(207) 457-6056

NPI assigned

Jan 31, 2009

Last updated

Jan 31, 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

Gary Paul Grover

Title

Ceo

Phone

(207) 651-4295

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1233360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233360000000",
    "number": "1881832640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 DEPOT RD",
            "city": "LEBANON",
            "state": "ME",
            "postal_code": "040273347",
            "telephone_number": "207-651-4295",
            "fax_number": "207-457-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DEPOT RD",
            "city": "LEBANON",
            "state": "ME",
            "postal_code": "040273347",
            "telephone_number": "207-651-4295",
            "fax_number": "207-457-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO BASICS BEHAVIORAL HEALTH SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-31",
        "last_updated": "2009-01-31",
        "status": "A",
        "authorized_official_last_name": "GROVER",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-651-4295"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "ME",
            "license": "CS1-11-963",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "432442400",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Back to Basics Childcare Center, Inc.
• Liana Bolen
• Erin Bourque, FNP-C
• Helene Sokol Cass, M.S., CCC-SLP
• Jeffrey Hammersmith, FP-C

• Developmentally Disabled Services Day Training Agency in Lebanon, ME
• Providers in Lebanon, ME by specialty
• Developmentally Disabled Services Day Training Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 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.