MR. EARL M NICKERSON (NPI# 1144359910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144359910 |
Entity Type | Individual |
Full Name | MR. EARL M NICKERSON |
Practice Address |
9 Doak Rd Belfast ME 04915 |
Practice Telephone | 2073383605 |
Practice Fax Number | 2073380589 |
Mailing Telephone | 2073383605 |
Mailing Fax Number | 2073380589 |
Enumeration Date | 2007-03-05 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | ALLSL916 | ME | Residential Treatment Facilities |
Street Address |
9 DOAK RD |
City | BELFAST |
State | ME |
Zip Code | 04915 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578049201 | Elizabeth Ann Owen-mishou | Speech-Language Pathologist | Waldo County General Hospital/mainehealth, 118 Northport Avenue, Belfast, ME 04915 | 2018-07-16 |
1407365489 | Steven James Hoffman | Physical Therapist | 80 Spring St., Belfast, ME 04915 | 2017-09-22 |
1104281534 | Private Home Care, Inc. | Technician | 243 High St., 2nd Floor, Belfast, ME 04915 | 2015-12-30 |
1568836559 | Carmen Elizabeth Williams | Social Worker | 41 Wight Street, Belfast, ME 04915 | 2015-11-14 |
1982099453 | Just Me In Home Care | In Home Supportive Care | 126 Harriman Rd, Swanville, ME 04915 | 2015-04-01 |
1730516576 | Lauren Mcelwain | Social Worker | 109 Northport Ave., Apt. 4, Belfast, ME 04915 | 2013-10-10 |
1679824312 | Robert John Struba | Acupuncturist | 34 Race Street, Belfast, ME 04915 | 2012-09-20 |
1629371471 | Coastal Maine Behavioral Health Inc. | Case Management | 96 High St., A, Belfast, ME 04915 | 2010-12-17 |
1043524523 | Daniella Macleod | Counselor | 24 Sweetser Drive, Belfast, ME 04915 | 2010-07-27 |
1104060672 | Waldo County Child Development Service | Speech-Language Pathologist | 139 Northport Avenue, Belfast, ME 04915 | 2009-04-28 |
Find all providers in zip 04915 |
Taxonomy Code | 320600000X |
Grouping | Residential Treatment Facilities |
Classification | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental disabilities and/or mental retardation and are not able to live independently. |
Notes: [7/1/2003: new] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740404722 | Terry Rich Bowen | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 13 Parkside Lane, Belfast, ME 04915 | 2007-04-12 |
1629197835 | Linda Arline Gordon | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 108 Union Street, Belfast, ME 04915-6731 | 2007-03-28 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1265033088 | Palms Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1500 Forest Ave Apt 13d, Portland, ME 04103-1846 | 2020-11-06 |
1588264378 | Amahoro LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 59 Starboard Dr, Cape Elizabeth, ME 04107-9647 | 2020-10-29 |
1194340646 | Veritas Care of Maine Inc | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 570 Brighton Ave Ste 2, Portland, ME 04102-2355 | 2020-06-10 |
1497387708 | Paradise Residential Services LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 6 Stephanie Dr, Gorham, ME 04038-1394 | 2020-02-05 |
1679104673 | Dynamic Alternative Services | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 171 Brook St, Sanford, ME 04073-2505 | 2020-01-29 |
1811528920 | Alternative Residential Care | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 14 Joes Rd, Windham, ME 04062-4515 | 2020-01-28 |
1790321578 | Supportive Partnerships | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 1 Fellows St, Portland, ME 04103-2414 | 2019-11-26 |
1437792199 | Atlantic Community Support LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 75 Bishop St Ste 13, Portland, ME 04103-2614 | 2019-10-24 |
1396390811 | Golden Group Home Services, LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 40 Bernard Rd, Portland, ME 04103-3611 | 2019-08-02 |
1588217897 | Blue Star Homecare LLC | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 23 Myrtle St Apt 102, Biddeford, ME 04005-3578 | 2019-07-17 |
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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.