KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND INC NPI 1700958022

NPI Information

NPI: 1700958022
Provider Name: KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND INC
Classification: Residential Treatment Facility, Emotionally Disturbed Children - 322D00000X
Entity Type: Organization
Address:
16 KIDSPEACE WAY
GRAHAM LAKE CAMPUS
ELLSWORTH, ME
ZIP 04605
Phone: (207) 667-0909
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KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND INC is a residential treatment facility emotionally disturbed children in Ellsworth, ME. The provider is a residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently. KIDSPEACE NATIONAL CENTERS OF NEW ENGLAND INC NPI is 1700958022. The provider is registered as an organization entity type.

The provider's business location address is:

16 KIDSPEACE WAY
GRAHAM LAKE CAMPUS
ELLSWORTH, ME
ZIP 04605
Phone: (207) 667-0909
Fax: (207) 667-6348

The provider's authorized official is Michael W Slack .
The authorized official title is Vp For Marketing And Business Devel and has the following contact phone number (800) 854-3123.

The enumeration date for this NPI number is 11/14/2006 and was last updated on 7/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	322D00000X	Residential Treatment Facility, Emotionally Disturbed Children		216402	MAINE	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	123430001	MEDICAID	MAINE
2	58580	MEDICAID	CONNECTICUT
3	30833999	MEDICAID	NEW HAMPSHIRE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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