Organization Active NPI

Pinecrest Haven

  • Adult Day Care Clinic/Center
  • Bangor, ME
National Provider Identifier
1952271207
Registry record updated Nov 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
PINECREST HAVEN
Practice address
60 West St
Bangor, ME 04401-5809
Phone
(207) 922-0049
NPI assigned
Nov 10, 2025
Last updated
Nov 10, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2025

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

Authorized official

Name
Mrs. Georgia Simone Samuels
Title
Co-Owner
Phone
(207) 922-0049

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X NU Primary

Addresses

Primary practice location

60 West St
Bangor, ME 04401-5809

Mailing address

42 Dana Dr
Bangor, ME 04401-2749

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1762732800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1952271207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 DANA DR",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044012749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 WEST ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044015809",
            "telephone_number": "207-922-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PINECREST HAVEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-10",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "SAMUELS",
        "authorized_official_first_name": "GEORGIA",
        "authorized_official_middle_name": "SIMONE",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "207-922-0049",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 10, 2025; 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.