NPIMap

Organization Active NPI

Alternative Health Services of St. Joseph Inc.

Doing business as St. Joseph Homecare and Hospice

  • Home Health Agency
  • Bangor, ME
National Provider Identifier
1972503365
Registry record updated Jul 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
38335 Issued in ME
Legal business name
ALTERNATIVE HEALTH SERVICES OF ST. JOSEPH INC.
Doing business as
St. Joseph Homecare and Hospice
Practice address
900 Broadway BLDG 4
Bangor, ME 04401-1900
Phone
(207) 907-1810
Fax
(207) 907-1928
NPI assigned
Jul 28, 2005
Last updated
Jul 17, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2019

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

Authorized official

Name
Mr. Michael Hendrix
Title
Chief Financial Officer
Phone
(207) 907-1600

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 38335 ME Primary
Community Based Hospice Care Agency 251G00000X 36863 ME

Addresses

Primary practice location

900 Broadway BLDG 4
Bangor, ME 04401-1900

Mailing address

PO Box 934
Bangor, ME 04402-0934
Phone (413) 406-6078

Other names 1

  • St. Joseph Homecare and Hospice Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090922000054 ME Part A Provider - Home Health Agency 1850447509 Practice locations: Bangor, ME
O20120719000037 ME Part A Provider - Hospice 1850447509 Practice locations: Bangor, ME

NPI to CCN mapping 2

The Medicare certification numbers (CCNs) connected to NPI 1972503365. Details of each certification follow.

Home health agency certification: CCN 207033

Legal name
ALTERNATIVE HEALTH SERVICES OF ST. JOSEPH INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Sep 11, 1987
Last certification
Jul 18, 2017
Ownership / control type
Non-Profit
Organization structure
CorporationNon-profit
Incorporated
Jan 2, 1987 in ME
Enrollment address
900 Broadway
BLDG 4
Bangor, ME 04401-1900

Hospice certification: CCN 201504

Legal name
ALTERNATIVE HEALTH SERVICES OF ST. JOSEPH INC.
Doing business as
ST. JOSEPH HOSPICE
Certification status
Active
Provider type (POS)
Hospice
Participating since
May 29, 1991
Last certification
Jan 28, 2020
Ownership / control type
Other
Organization structure
CorporationNon-profit
Incorporated
Jan 2, 1987 in ME
Enrollment address
900 Broadway
BLDG 4
Bangor, ME 04401-1900

Care Compare: Home health agency

Medicare Care Compare
Listed as
St Joseph HomecareCCN 207033 · All quality measures
Overall star rating
3 of 5
Ownership
Non-Profit
Certified
Sep 11, 1987
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

Care Compare: Hospice

Medicare Care Compare
Listed as
St. Joseph HospiceCCN 201504 · All quality measures
Ownership
Non-Profit
Certified
May 29, 1991
Medicare certification status
ActiveFrom the Provider of Services file

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
20D0877361St Joseph Homecare & Hospice900 Broadway, Building 4, Bangor, ME 04401Certificate of waiverSep 29, 2027

National Provider Directory

National Provider Directory

Locations

279 Center St
Bangor, ME 04401
Phone (207) 907-1810

900 Broadway
Bldg 4
Bangor, ME 04401
Phone (207) 907-3276

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Mary B Prybylo Individual Contracted Managing EmployeeCeo & President Sep 1, 2011 7.14%
Corporate OfficerCeo & President Sep 1, 2011 7.14%
Corporate DirectorCeo & President Sep 1, 2011 7.14%
Contracted Managing EmployeeCeo/President Sep 1, 2011 7.14%
Corporate OfficerCeo/President Sep 1, 2011 7.14%
Corporate DirectorCeo/President Sep 1, 2011 7.14%
Jims Jean-Jacques Individual Corporate Director Jan 1, 2023 7.14%
Robert a Clark Individual Corporate OfficerChairperson Jan 1, 2022 7.14%
Corporate DirectorChairperson Feb 28, 2014 7.14%
William a Buckley Individual Corporate Director Feb 28, 2020 7.14%
St. Joseph Healthcare Foundation, Inc Organization, Bangor, ME Corporation, Non-profit 5% Or Greater Direct Ownership Interest Aug 31, 1983 100%
Stephen J Grubbs Individual Corporate OfficerPresident/Ceo of Covenant Health Apr 26, 2019
William Richard Wood Individual Corporate Director Aug 27, 2021 7.14%
Rebecca Lyn Cyr Whitmore Individual Corporate OfficerVice Chair Jan 1, 2022 7.14%
Corporate DirectorVice Chair Aug 1, 2018 7.14%
Curtis Kimball Individual Corporate Director Feb 28, 2020 7.14%
Bradley S Ryder Individual Corporate Director Jun 1, 2014 7.14%
Rosalind Prince Gilman Individual Corporate Director Feb 28, 2020 7.14%
Michael a Hendrix Individual Contracted Managing EmployeeCfo & Board Treasurer Jan 30, 2014
Corporate OfficerCfo & Board Treasurer Jan 30, 2014
Corporate DirectorCfo & Board Treasurer Jan 30, 2014
Jennifer M Khavari Individual Corporate Director Apr 29, 2022 7.14%
Donna L Berry Individual Corporate OfficerSecretary Mar 7, 2019
Judith Avery Josiah-Martin Individual Corporate Director Feb 25, 2022 7.14%
Anita Lorraine Haskell Individual Corporate Director Feb 28, 2020 7.14%
Heather S Evans Individual Corporate Director Jan 1, 2021 7.14%
Covenant Health Organization, Tewksbury, MA Corporation, Non-profit 5% Or Greater Indirect Ownership Interest Jul 29, 2010 100%
Lori Lou Varney Individual Corporate Director Feb 25, 2022 7.14%
Ganesha S Santhyadka Individual Corporate Director Jan 1, 2019 7.14%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 14

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 14

Practitioners & affiliated clinicians

Practitioners 7

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.

Affiliated clinicians 31

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1972503365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 934",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044020934",
            "telephone_number": "413-406-6078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 BROADWAY BLDG 4",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044011900",
            "telephone_number": "207-907-1810",
            "fax_number": "207-907-1928"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTERNATIVE HEALTH SERVICES OF ST. JOSEPH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "HENDRIX",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "207-907-1600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "ME",
            "license": "38335",
            "primary": true
        },
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "ME",
            "license": "36863",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Joseph Homecare and Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bangor, ME

Sources for this page

Verify at the official NPI Registry.