KIMBERLY IVERNE RODRIGUEZ (NPI# 1386878346) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386878346 |
| Entity Type | Individual |
| Full Name | KIMBERLY IVERNE RODRIGUEZ |
| Credential | CRMA |
| Practice Address |
52 Gardiner Street Patten ME 04765 |
| Mailing Address |
Po Box 226 Patten ME 04765-0226 |
| Practice Telephone | 2075282203 |
| Mailing Telephone | 2075282203 |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2009-05-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 202450000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598320400 | Kimberly Rodriguez | Behavior Technician | 35435 Orange Grove Ln, Leesburg, FL 34788-2988 | 2019-05-06 |
| 1093208183 | Kimberly S Rodriguez | Midwife | 550 White Haven Rd, Bear Creek, PA 18602 | 2018-06-13 |
| 1144747569 | Kimberly Savanannah Rodriguez | Social Worker | 2600 Redondo Ave., 6th Floor, Long Beach, CA 90806 | 2017-08-25 |
| 1013376912 | Kimberly Rodriguez | Behavioral Analyst | 7742 Genesta Ave, Van Nuys, CA 91406-2137 | 2016-02-19 |
| 1851761290 | Kimberly Aimett Rodriguez | Speech-Language Pathologist | 2261 Casa Verano Way, Apt 103, Kissimmee, FL 34744-5972 | 2015-09-28 |
| 1164812764 | Kimberly Rodriguez | Occupational Therapy Assistant | 2085 Vista Pkwy, West Palm Beach, FL 33411-2719 | 2015-02-03 |
| 1104168046 | Kimberly Dawn Rodriguez | Pharmacist | 4937 Nw 106th Ave, Coral Springs, FL 33076-2709 | 2013-03-18 |
| 1386851871 | Kimberly Rodriguez | Counselor | 12165 W. Center Rd, Suite 70, Omaha, NE 68144 | 2007-05-16 |
| 1861612566 | Kimberly Dawn Rodriguez | Licensed Practical Nurse | 152 Lilac Ln, Ashland, OH 44805-1531 | 2007-04-26 |
| 1407886922 | Kimberly Rodriguez | Physical Therapist | 100360 Overseas Hwy, Key Largo, FL 33037-2586 | 2006-07-03 |
| Street Address |
52 GARDINER STREET |
| City | PATTEN |
| State | ME |
| Zip Code | 04765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285043869 | Angela Anderson | Registered Nurse | 30 Houlton St., Patten, ME 04765 | 2014-08-07 |
| 1649404609 | Randall S Roberts | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 52 Gardner Street, Apt A, Patten, ME 04765 | 2009-05-06 |
| 1528260783 | Town of Patten | Ambulance | 27 Dearborn St., Patten, ME 04765 | 2007-06-01 |
| 1700941333 | Green Valley Association | Day Training, Developmentally Disabled Services | 69 David St, Island Falls, ME 04765 | 2006-12-26 |
| 1518022151 | Green Valley Association | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13 Gardner Street, Patten, ME 04765 | 2006-12-26 |
| 1639230113 | Chandler Bay Group, Inc | Skilled Nursing Facility | 83 Houlton Road, Patten, ME 04765 | 2006-12-12 |
| 1811917545 | Denise M Marquis | Nurse's Aide | 30 Houlton Street, Patten, ME 04765 | 2006-07-19 |
| 1609824747 | Ronald I Blum | Specialist | 17 Founders Street, Patten, ME 04765 | 2006-05-04 |
| 1699770222 | Rose M Fuchs | Family Medicine | 17 Founders St, Patten, ME 04765 | 2005-06-20 |
| 1720648116 | Crystal Holly Pipes | Registered Nurse | 529 S Patten Rd, Patten, ME 04765 | 2019-06-18 |
| Find all providers in zip 04765 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649404609 | Randall S Roberts | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 52 Gardner Street, Apt A, Patten, ME 04765 | 2009-05-06 |
| 1518022151 | Green Valley Association | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13 Gardner Street, Patten, ME 04765 | 2006-12-26 |
| 1437295359 | Green Valley Association | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13 Gardner Street, Patten, ME 04765 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710585591 | Assurance Residential Services | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 10 Gracelawn Rd Apt 3, Auburn, ME 04210-6557 | 2020-10-13 |
| 1033722236 | Maine Shared Living | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 715 Upper St, Turner, ME 04282-3808 | 2020-08-26 |
| 1730797465 | Dirigo Support Professionals LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 176 Broad St Apt 1, Auburn, ME 04210-5610 | 2020-07-20 |
| 1154948206 | Quality Care Access, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 22 Wayne St, Portland, ME 04102-2228 | 2020-07-05 |
| 1558987438 | Moonlight Group Homes LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 253 Lisbon Street, Lewiston, ME 04240-7704 | 2020-06-17 |
| 1629617477 | Compass Bridges LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 14 Arrowhead Dr, Brunswick, ME 04011-7420 | 2019-12-26 |
| 1538705637 | Grace Support Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 86 Euclid Ave, Portland, ME 04103-1240 | 2019-11-23 |
| 1467097709 | Pine Peak Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1395 Congress St, Portland, ME 04102-2120 | 2019-11-11 |
| 1306480108 | Pine Peak Care LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 13 Sara Ln, Portland, ME 04103-3622 | 2019-11-05 |
| 1821648650 | Advanced Care Solutions LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 88 Knox St, Lewiston, ME 04240-7406 | 2019-09-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.