SHEPHERD CARE, LLC (NPI# 1669932323) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669932323 |
| Entity Type | Organization |
| Organization Name | SHEPHERD CARE, LLC |
| Practice Address |
560 Main St Apt 1 South Portland ME 04106-5409 |
| Mailing Address |
500 Forest Ave Ste 8 Portland ME 04101-1520 |
| Practice Telephone | 2073528572 |
| Mailing Telephone | 2073528572 |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2019-03-20 |
| Authorized Official Name | YUGU ALFRED YOBO (OWNER) |
| Authorized Official Telephone | 2074829531 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | Residential Treatment Facilities | ||
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | Residential Treatment Facilities | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| Street Address |
560 MAIN ST APT 1 |
| City | SOUTH PORTLAND |
| State | ME |
| Zip Code | 04106-5409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912513748 | Rayna Louise Sage | Behavior Technician | 50 Donald Beaver Drrive, Ste B, Portland, ME 04106 | 2020-09-17 |
| 1972127330 | Scott M Davis Md LLC | Internal Medicine | 89 Cannon Road, South Portland, ME 04106 | 2020-06-02 |
| 1568013936 | Clara Cassidy | Behavior Technician | 50 Donald Bean Dr, Ste B, South Portland, ME 04106 | 2019-09-26 |
| 1336614346 | Kari Whitney | Nurse Practitioner | Vna Home Health Hospice, 50 Foden Road, Suite 1, South Portland, ME 04106 | 2018-10-05 |
| 1588152193 | Kristen F. Pierce | Counselor | 100 Waterman Drive, Suite 201, South Portland, ME 04106 | 2018-04-30 |
| 1649779224 | Jennifer Rene Johnson | Social Worker | 135 Westbrook St, South Portland, ME 04106 | 2018-02-08 |
| 1154847721 | Integral Nutrition, LLC | Dietitian, Registered | 59 Baltimore Avenue, South Portland, ME 04106 | 2017-08-16 |
| 1730619610 | John Preston Powell | Psychiatry & Neurology | 68 B Street Apt 4, South Portland, ME 04106 | 2017-06-14 |
| 1649706268 | Gisselle Mani | Student in an Organized Health Care Education/Training Program | 30 Lydia Ln Apt 2115, South Portland, ME 04106 | 2017-05-02 |
| 1245786987 | Jonathan Frank Olmes | Optometrist | 335 Maine Mall Rd., South Portland, ME 04106 | 2016-09-01 |
| Find all providers in zip 04106 | ||||
| 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 | ||||
| City | SOUTH PORTLAND |
| Zip Code | 04106 |
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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.