PROVIDENCE SERVICE CORPORATION (NPI# 1710222534) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710222534 |
| Entity Type | Organization |
| Organization Name | PROVIDENCE SERVICE CORPORATION |
| Practice Address |
2 Davenport Cir Suite 4; Achieve Program Bath ME 04530-2880 |
| Mailing Address |
Po Box 758866 Baltimore MD 21275-8866 |
| Practice Telephone | 2074436200 |
| Mailing Telephone | 2073730620 |
| Enumeration Date | 2012-12-05 |
| Last Update Date | 2012-12-05 |
| Authorized Official Name | NICOLE ZENGA (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 2073730620 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 392123 | ME | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 191700000 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447404082 | Providence Service Corporation | Exclusive Provider Organization | 2211 E Missouri Ave, E243, El Paso, TX 79903-3807 | 2008-11-10 |
| 1851728042 | Providence Service Corporation | Community/Behavioral Health | 2215 N Broadway, Santa Ana, CA 92706-2663 | 2013-10-02 |
| 1982949699 | Providence Service Corporation | Community/Behavioral Health | 469 Main St, Springvale, ME 04083-1870 | 2012-12-06 |
| 1235271222 | Providence Service Corporation | Case Management | 301 N High St, Antlers, OK 74523-2238 | 2007-02-13 |
| 1821003658 | Providence Service Corporation | Public Health or Welfare | 4645 W Gore Blvd, Suite 5, Lawton, OK 73505-6041 | 2006-07-30 |
| Street Address |
2 DAVENPORT CIR SUITE 4; ACHIEVE PROGRAM |
| City | BATH |
| State | ME |
| Zip Code | 04530-2880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366771438 | Family Focus | Case Management | 2 Davenport Cir, Bath, ME 04530-2880 | 2009-12-18 |
| 1942541321 | Jamie Laura Pratt | Psychologist | 2 Davenport Cir, Suite 20, Bath, ME 04530-2880 | 2013-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932721230 | Eric Edward Morse | Pharmacy | Wilsens Drug Store, 114 Front St, Bath, ME 04530 | 2020-05-11 |
| 1659825818 | Lacey Andrews Gale | Social Worker | 72 Front St Ste 1, Bath, ME 04530 | 2016-08-05 |
| 1619368024 | Cathleen D Koslosky | Nurse Practitioner | 108 Centre St Ste 200, Bath, ME 04530 | 2015-02-08 |
| 1558760801 | Carrie M Werner | Naturopath | 92 Commercial St, Bath, ME 04530 | 2014-08-21 |
| 1457765125 | Mandy Winne | Massage Therapist | 9 Centre Street, Bath, ME 04530 | 2014-06-20 |
| 1295162618 | Dusty Jones | Behavioral Analyst | 995 Middle Street, Bath, ME 04530 | 2013-09-30 |
| 1659520096 | Tedford Housing-evergreen Woods | Case Management | 10 James Way, Bath, ME 04530 | 2008-09-10 |
| 1467630509 | Nancy Harris Jaeger | Social Worker | 141 Front St, Bath, ME 04530 | 2008-01-31 |
| 1740463009 | Bruce Alan Verrill | Dentist | 42 Front Street, Bath, ME 04530 | 2007-12-10 |
| 1699958249 | Myron K Krueger Md Pa | Internal Medicine | 765 High Street, Bath, ME 04530 | 2007-12-06 |
| Find all providers in zip 04530 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174702781 | Pathways, Inc | Community/Behavioral Health | 5 Vargason Pl, Bath, NY 14810-1200 | 2007-10-31 |
| 1134521206 | Grac Recovery Inc. | Community/Behavioral Health | 9 Park St, Bath, ME 04530-2828 | 2014-09-20 |
| 1053621896 | Sccmhc/scasas | Community/Behavioral Health | 115 Liberty Street, Bath, NY 14810 | 2010-10-14 |
| 1639404064 | Proaction of Steuben and Yates, Inc. | Community/Behavioral Health | 117 E Steuben St, Bath, NY 14810-1636 | 2009-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609476852 | Allied Community Services LLC | Community/Behavioral Health | 476 Sabattus St, Lewiston, ME 04240-4111 | 2020-10-27 |
| 1124627765 | Peace Care Services LLC | Community/Behavioral Health | 145 Lisbon St Ste 508, Lewiston, ME 04240-7241 | 2020-10-24 |
| 1770181877 | Renewal Family Center, LLC | Community/Behavioral Health | 10 Learners Drive, Augusta, ME 04330 | 2020-10-12 |
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1497371868 | Touchstone Support Services LLC | Community/Behavioral Health | 247 Lisbon St # 2, Lewiston, ME 04240-7704 | 2020-06-22 |
| 1770106916 | Rolling Hills Enterprises, Inc. | Community/Behavioral Health | 124 Canal St Ste 2, Lewiston, ME 04240-7711 | 2020-05-22 |
| 1871134478 | Nicole Mank, Lcsw, LLC | Community/Behavioral Health | 126 Western Ave # 1026, Augusta, ME 04330-7249 | 2019-10-04 |
| 1699328336 | Nancy Yombe | Community/Behavioral Health | 280 Stetson Rd, Lewiston, ME 04240-2430 | 2019-07-22 |
| 1942867676 | At The Helm Counseling and Case Management, LLC | Community/Behavioral Health | 64 Paris St, Norway, ME 04268-5634 | 2019-05-29 |
| 1629530530 | Fraser Clinical Consultation Services, LLC | Community/Behavioral Health | 96 Harlow St Ste 214, Bangor, ME 04401-4981 | 2019-04-01 |
| Find all providers with the same taxonomy | ||||
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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.