MR. RANDALL S ROBERTS


Address: 52 Gardner Street, Apt A, Patten, ME 04765
Phone: 2075385279

MR. RANDALL S ROBERTS (NPI# 1649404609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649404609
Entity Type Individual
Full Name MR. RANDALL S ROBERTS
Practice Address 52 Gardner Street
Apt A
Patten
ME 04765
Mailing Address Po Box 226
Patten
ME 04765-0226
Practice Telephone 2075385279
Mailing Telephone 2075385279
Enumeration Date 2009-05-06
Last Update Date 2009-05-06
Gender Code M
Is Sole Proprietor Y

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
ME 432861500 05

Other Providers RANDALL ROBERTS

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1033207535 Randall Thomas Roberts Chiropractor 1240 E Highway 193, Suite G8, Layton, UT 84040-8544 2006-10-10
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Office Location

Street Address 52 GARDNER STREET
APT A
City PATTEN
State ME
Zip Code 04765

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1285043869 Angela Anderson Registered Nurse 30 Houlton St., Patten, ME 04765 2014-08-07
1386878346 Kimberly Iverne Rodriguez Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 52 Gardiner Street, 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
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Taxonomy Information

Taxonomy Code 320900000X
Grouping Residential Treatment Facilities
Classification Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1386878346 Kimberly Iverne Rodriguez Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 52 Gardiner Street, 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

Providers in the same taxonomy and state

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
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Competitor

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City PATTEN
Zip Code 04765

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Dataset Information

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.

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