WOODSIDE RESIDENTIAL, INC (NPI# 1730414921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730414921 |
| Entity Type | Organization |
| Organization Name | WOODSIDE RESIDENTIAL, INC |
| Practice Address |
54 Barrows Dr Topsham ME 04086-1324 |
| Mailing Address |
814 Alexander Reed Rd Richmond ME 04357-3411 |
| Practice Telephone | 2077259330 |
| Practice Fax Number | 2077259330 |
| Mailing Telephone | 2077372443 |
| Mailing Fax Number | 2077372443 |
| Enumeration Date | 2009-10-06 |
| Last Update Date | 2009-10-06 |
| Authorized Official Name | MS. LINDA COLLINS (ADMINISTRATOR) |
| Authorized Official Telephone | 2077372443 |
| Authorized Official Credential | DSP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | ALLS 3081 | ME | Residential Treatment Facilities |
| Street Address |
54 BARROWS DR |
| City | TOPSHAM |
| State | ME |
| Zip Code | 04086-1324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770196040 | Martha Densmore | Registered Nurse | 49 Topsham Fair Mall Rd., Topsham, ME 04086 | 2020-08-26 |
| 1972156727 | Wanho Lew | Dentist | 127 Topsham Fail Mall Rd., Topsham, ME 04086 | 2019-07-22 |
| 1326510595 | Apex Residential Support Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 196 Meadow Cross Rd, Topsham, ME 04086 | 2018-12-27 |
| 1891143681 | Kai N Cheng | Physician Assistant | 105 Topsham Fair Mall Rd Ste 8, Topsham, ME 04086 | 2016-06-02 |
| 1487028775 | Reform Physical Therapy, Inc | Physical Therapist | 439 Lewiston Rd, Topsham, ME 04086 | 2015-11-24 |
| 1457773301 | Kelly Fritz | Physical Therapist | 126 Main St Ste 3, Topsham, ME 04086 | 2014-01-13 |
| 1831493964 | Diane Lamere-wallace | Occupational Therapist | 19 Perkins Avenue, Topsham, ME 04086 | 2011-01-04 |
| 1376702597 | Julia Sullivan Cabral | Social Worker | 63 Elm Street, Ste B, Topsham, ME 04086 | 2008-06-03 |
| 1285830554 | Brian Roger Haney | Internal Medicine | 105 Topsham Fair Mall Rd Unit 1, Topsham, ME 04086 | 2007-06-25 |
| 1003917501 | Nancy A Porr | Nurse Practitioner | 4 Horton Place, Suite 101, Topsham, ME 04086 | 2006-09-26 |
| Find all providers in zip 04086 | ||||
| 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 |
|---|---|---|---|---|
| 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.