SOUTHERN HARBOR ELDERCARE SERVICES (NPI# 1750873592) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750873592 |
| Entity Type | Organization |
| Organization Name | SOUTHERN HARBOR ELDERCARE SERVICES |
| Practice Address |
12 Pulpit Harbor Road North Haven ME 04853 |
| Mailing Address |
Po Box 220 North Haven ME 04853 |
| Practice Telephone | 2078672345 |
| Practice Fax Number | 2078635027 |
| Mailing Telephone | 2078672345 |
| Mailing Fax Number | 2078635027 |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |
| Authorized Official Name | MRS. KATHI LOVELL (PRESIDENT) |
| Authorized Official Telephone | 2078674633 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHERN HARBOR ELDERCARE SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | ME | Nursing & Custodial Care Facilities | |
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
ME | Nursing & Custodial Care Facilities |
| Street Address |
12 PULPIT HARBOR ROAD |
| City | NORTH HAVEN |
| State | ME |
| Zip Code | 04853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942323639 | Town of North Haven | Ambulance | 16 Town Office Square, North Haven, ME 04853 | 2007-04-09 |
| 1306922281 | Town of North Haven | Clinic/Center | 135 Main St., North Haven, ME 04853 | 2006-10-31 |
| 1154468486 | Elizabeth Puryear Hill | Nurse Practitioner | 135 Main Street, North Haven, ME 04853 | 2007-01-30 |
| 1861558488 | Dorie Anne Henning | Nurse Practitioner | 135 Main Street, North Haven, ME 04853 | 2006-12-28 |
| 1619184207 | Msad 7 | Local Education Agency (LEA) | Rr 1 Box 699, North Haven, ME 04853-9707 | 2007-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407463557 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 555 Universal Dr N, North Haven, CT 06473-3142 | 2020-09-23 |
| 1043823347 | Yunmin Chen | Nurse Practitioner | 269 Spring Rd, North Haven, CT 06473 | 2020-08-26 |
| 1457977654 | Clove Tree Community Acupuncture | Acupuncturist | 41 Middletown Ave # 2ndf, North Haven, CT 06473-3939 | 2020-06-23 |
| 1700407764 | Nathan Lorenzo Smith | Social Worker | 100 State St Apt 148, North Haven, CT 06473-2227 | 2020-04-30 |
| 1215566971 | Michelle Ripke | Student in an Organized Health Care Education/Training Program | 132 Sackett Point Rd Fl 2, North Haven, CT 06473-3214 | 2020-04-05 |
| 1104450766 | Ruel Dixon | Behavioral Analyst | 100 State St Apt 85, North Haven, CT 06473-2219 | 2020-02-23 |
| 1184264616 | James Lewis Hexter | Social Worker | 19 Great Meadow Dr, North Haven, CT 06473-4038 | 2020-01-13 |
| 1073153680 | Maryam Oshomah | Nurse Practitioner | 1660 Ridge Rd, North Haven, CT 06473-2046 | 2020-01-11 |
| 1750920369 | Shana Nicole Pettway | Behavior Technician | 145 Fitch St, North Haven, CT 06473-3706 | 2019-12-30 |
| 1790321727 | Embracing Your Difference | Counselor | 410 State St Rm 7, North Haven, CT 06473-3149 | 2019-11-25 |
| Find all providers in NORTH HAVEN | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053762567 | Anchor Senior Care Residence | Custodial Care Facility | 25 Oak Street, Springvale, ME 04083 | 2016-06-27 |
| 1417267535 | Siesta Haven II | Custodial Care Facility | 33 James St, Bangor, ME 04401-4634 | 2010-10-08 |
| 1982933859 | Maxine Y Roberts | Custodial Care Facility | 231 Grove Street, Lewiston, ME 04240 | 2009-12-23 |
| 1871822478 | Sisters of The Heart | Custodial Care Facility | 60 Carmel Rd S, Hampden, ME 04444-3122 | 2009-12-10 |
| 1154657401 | Rhonda E. Chambers | Custodial Care Facility | 152 South St, Calais, ME 04619-1324 | 2009-10-21 |
| 1477886711 | Lakeview Afch Inc | Custodial Care Facility | 10 E Broadway, Lincoln, ME 04457 | 2009-09-17 |
| 1447486162 | The Beacon Project | Custodial Care Facility | 131 Main Rd, Islesboro, ME 04848-4501 | 2009-06-09 |
| 1700010824 | Billie's Adult Residential Care Home P.a. | Custodial Care Facility | 8 Leonard St, Houlton, ME 04730-1708 | 2009-05-04 |
| 1427298272 | Graymoor | Custodial Care Facility | 24 Green St, Houlton, ME 04730-1637 | 2009-03-05 |
| 1679799365 | Nancy Ann Witherell | Custodial Care Facility | 22 Sandys Way, Minot, ME 04258-5021 | 2007-04-18 |
| Find all providers with the same taxonomy | ||||
| City | NORTH HAVEN |
| Zip Code | 04853 |
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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.