PENQUIS C.A.P., INC. (NPI# 1598830820) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598830820 |
| Entity Type | Organization |
| Organization Name | PENQUIS C.A.P., INC. |
| Other Organization Name | CAPTAIN MILLER HOUSE APTS |
| Practice Address |
262 Harlow St Bangor ME 04401-4952 |
| Mailing Address |
Po Box 1162 Bangor ME 04402-1162 |
| Practice Telephone | 2079733500 |
| Mailing Telephone | 2079733500 |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2018-12-10 |
| Authorized Official Name | KARA HAY (CEO) |
| Authorized Official Telephone | 2079733500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 164850000 | 05 |
| Other Name | Type Code |
|---|---|
| Captain Miller House Apts | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720087075 | Penquis C.a.p., Inc. | Community/Behavioral Health | 262 Harlow St, Bangor, ME 04401-4952 | 2005-07-19 |
| 1366872509 | Penquis C.a.p., Inc. | Custodial Care Facility | 262 Harlow St, Bangor, ME 04401-4952 | 2013-11-26 |
| 1508110271 | Penquis C.a.p., Inc. | Home Health | 262 Harlow St, Bangor, ME 04401-4952 | 2012-11-02 |
| 1649590902 | Penquis C.a.p., Inc. | Custodial Care Facility | 262 Harlow St, Bangor, ME 04401-4952 | 2010-06-09 |
| 1427282649 | Penquis C.a.p., Inc. | Case Management | 262 Harlow St, Bangor, ME 04401-4952 | 2009-05-04 |
| 1518034453 | Penquis C.a.p., Inc. | Day Training, Developmentally Disabled Services | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-29 |
| 1659448504 | Penquis C.a.p., Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-29 |
| 1619043098 | Penquis C.a.p., Inc. | Community/Behavioral Health | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-28 |
| 1508932898 | Penquis C.a.p., Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-28 |
| 1649346156 | Penquis C.a.p., Inc. | Day Training, Developmentally Disabled Services | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-27 |
| Street Address |
262 HARLOW ST |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-4952 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720087075 | Penquis C.a.p., Inc. | Community/Behavioral Health | 262 Harlow St, Bangor, ME 04401-4952 | 2005-07-19 |
| 1366872509 | Penquis C.a.p., Inc. | Custodial Care Facility | 262 Harlow St, Bangor, ME 04401-4952 | 2013-11-26 |
| 1508110271 | Penquis C.a.p., Inc. | Home Health | 262 Harlow St, Bangor, ME 04401-4952 | 2012-11-02 |
| 1649590902 | Penquis C.a.p., Inc. | Custodial Care Facility | 262 Harlow St, Bangor, ME 04401-4952 | 2010-06-09 |
| 1427282649 | Penquis C.a.p., Inc. | Case Management | 262 Harlow St, Bangor, ME 04401-4952 | 2009-05-04 |
| 1518034453 | Penquis C.a.p., Inc. | Day Training, Developmentally Disabled Services | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-29 |
| 1659448504 | Penquis C.a.p., Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-29 |
| 1619043098 | Penquis C.a.p., Inc. | Community/Behavioral Health | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-28 |
| 1508932898 | Penquis C.a.p., Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-28 |
| 1649346156 | Penquis C.a.p., Inc. | Day Training, Developmentally Disabled Services | 262 Harlow St, Bangor, ME 04401-4952 | 2006-11-27 |
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| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
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| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
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| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
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| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
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| 1467756221 | Cornerstone I Inc. | Community Based Residential Treatment Facility, Mental Illness | 59859 M 43, Bangor, MI 49013-9617 | 2011-01-07 |
| 1427382522 | New Communities, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1605 Essex Street, Bangor, ME 04401 | 2009-09-23 |
| 1720153836 | Ohi | Community Based Residential Treatment Facility, Mental Illness | 203 Maine Ave, Bangor, ME 04401-4331 | 2006-11-22 |
| 1134178304 | Community Psychological Center, Inc. | Community Based Residential Treatment Facility, Mental Illness | 715 Pennsylvania Ave, Bangor, PA 18013-1740 | 2006-05-08 |
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|---|---|---|---|---|
| 1477068757 | Cornerstones of Maine LLC | Community Based Residential Treatment Facility, Mental Illness | 20 Fairfield Hill Rd, Kennebunkport, ME 04046-5222 | 2017-12-07 |
| 1245528314 | 63 Washington Street | Community Based Residential Treatment Facility, Mental Illness | 63 Washington St, Camden, ME 04843-1581 | 2011-07-11 |
| 1952635039 | New Communities, Inc. | Community Based Residential Treatment Facility, Mental Illness | 109 Davis Avenue, Auburn, ME 04210 | 2009-09-23 |
| 1154557452 | The Opportunity Alliance | Community Based Residential Treatment Facility, Mental Illness | 1329 Broadway, South Portland, ME 04106-4110 | 2009-06-02 |
| 1629218409 | Bonnie Rae Condon | Community Based Residential Treatment Facility, Mental Illness | 3101 Portage Rd, Portage Lake, ME 04768-3111 | 2009-03-06 |
| 1952548943 | North Star Farm Inc. | Community Based Residential Treatment Facility, Mental Illness | 112 Thyngs Mill Road, No Waterboro, ME 04061 | 2009-01-13 |
| 1942411319 | Northern Maine General | Community Based Residential Treatment Facility, Mental Illness | 3400 Aroostook Rd, Eagle Lake, ME 04739-0310 | 2007-05-25 |
| 1932262920 | Sunrise Opportunities | Community Based Residential Treatment Facility, Mental Illness | 4 Harbor Lane, Milbridge, ME 04658 | 2006-12-19 |
| 1972666337 | Sunrise Opportunities | Community Based Residential Treatment Facility, Mental Illness | 4 Clark St, Eastport, ME 04631-1036 | 2006-12-18 |
| 1154497030 | Charlotte White Center | Community Based Residential Treatment Facility, Mental Illness | 9 Paul St, Dover Foxcroft, ME 04426-1050 | 2006-11-24 |
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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.