BONNIE RAE CONDON (NPI# 1629218409) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629218409 |
| Entity Type | Organization |
| Organization Name | BONNIE RAE CONDON |
| Practice Address |
3101 Portage Rd Portage Lake ME 04768-3111 |
| Practice Telephone | 2074356726 |
| Practice Fax Number | 2074356949 |
| Mailing Telephone | 2074356726 |
| Mailing Fax Number | 2074356949 |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2009-03-06 |
| Authorized Official Name | MRS. BONNIE RAE CONDON (CARE PROVIDER) |
| Authorized Official Telephone | 2074356726 |
| 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 |
| Street Address |
3101 PORTAGE RD |
| City | PORTAGE LAKE |
| State | ME |
| Zip Code | 04768-3111 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902232473 | David F. Scullion | Emergency Medicine | 480 West Rd., Portage, ME 04768 | 2013-09-17 |
| 1528296217 | Terriann Demerchant | In Home Supportive Care | 401 East Cottage Road, Portage Lake, ME 04768 | 2009-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528296217 | Terriann Demerchant | In Home Supportive Care | 401 East Cottage Road, Portage Lake, ME 04768 | 2009-07-01 |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1427382522 | New Communities, Inc. | Community Based Residential Treatment Facility, Mental Illness | 1605 Essex Street, Bangor, ME 04401 | 2009-09-23 |
| 1154557452 | The Opportunity Alliance | Community Based Residential Treatment Facility, Mental Illness | 1329 Broadway, South Portland, ME 04106-4110 | 2009-06-02 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | PORTAGE LAKE |
| Zip Code | 04768 |
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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.