SHALOM HOUSE INC. NPI 1992702955

NPI Information

NPI: 1992702955
Provider Name: SHALOM HOUSE, INC.
Classification: Community Based Residential Treatment Facility, Mental Illness - 320800000X
Entity Type: Organization
Address: 106 GILMAN ST
PORTLAND, ME
ZIP 04102
Phone: (207) 874-1080

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NPI Details

SHALOM HOUSE, INC. is a community based residential treatment facility mental illness in Portland, ME. The provider is a home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. SHALOM HOUSE, INC. NPI is 1992702955. The provider is registered as an organization entity type.

The provider's business location address is:

106 GILMAN ST
PORTLAND, ME
ZIP 04102-034
Phone: (207) 874-1080
Fax: (207) 874-1077

The provider's authorized official is Mary Haynes-rodgers .
The authorized official title is Executive Director and has the following contact phone number (207) 874-1080.

The enumeration date for this NPI number is 7/6/2005 and was last updated on 1/23/2009.

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	251B00000X	Case Management		229743	MAINE	No
2	320800000X	Community Based Residential Treatment Facility, Mental Illness		229743	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	Other Provider Identifier Issuer
1	16780000	MEDICAID	MAINE
2	SH ME1043	MEDICARE ID-TYPE UNSPECIFIED	MAINE	MEDICARE
3	167860101	MEDICAID	MAINE

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: 11/21/2025

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