NICHOLE LAVALLEY (NPI# 1821138017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821138017 |
| Entity Type | Individual |
| Full Name | NICHOLE LAVALLEY |
| Practice Address |
1461 Moosehead Trl Jackson ME 04921 |
| Mailing Address |
119 Lower Detroit Rd Plymouth ME 04969-3213 |
| Practice Telephone | 2079072631 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2019-10-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | ALLS 2297 | ME | Residential Treatment Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 119 Lower Detroit Rd, Plymouth, ME 049693213 | 2072572131 |
| Street Address |
1461 MOOSEHEAD TRL |
| City | JACKSON |
| State | ME |
| Zip Code | 04921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508931429 | Waldo County General Hospital | Ambulance | 55 Reynolds Road, Brooks, ME 04921 | 2006-11-24 |
| 1487720215 | Mainehealth | Clinic/Center | 55 Reynolds Road, Brooks, ME 04921 | 2006-11-24 |
| 1427077312 | Ronald E. Cormier | Nurse Practitioner | 55 Reynolds Road, Brooks, ME 04921-0159 | 2006-07-19 |
| 1710149257 | Allyn Eldridge | Occupational Therapy Assistant | 53 Hatch Rd, Jackson, ME 04921-3022 | 2008-06-26 |
| 1669404786 | John C. Kraft | Social Worker | 263 Village Rd, Jackson, ME 04921-3102 | 2006-07-07 |
| 1598278038 | Lisa A Audino | Social Worker | 467 Hadley Mill Rd, Jackson, ME 04921-3119 | 2017-11-07 |
| 1053780809 | Sarina Roche | Registered Nurse | 303 Monroe Hwy, Brooks, ME 04921-3420 | 2015-09-23 |
| 1750404596 | Dorothy Alonso Carin | Family Medicine | 55 Reynolds Rd, Box 159, Brooks, ME 04921-3637 | 2007-04-09 |
| 1043871585 | Julia Ann Ellis | Nurse Practitioner | 55 Reynolds Rd, Brooks, ME 04921-3637 | 2019-06-25 |
| 1700388477 | Brooks Ambulance Inc. | Ambulance | 55 Reynolds Rd, Brooks, ME 04921-3637 | 2018-03-08 |
| Find all providers in zip 04921 | ||||
| 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 |
|---|---|---|---|---|
| 1780208116 | Indya Daniels | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 262 Carriage House Dr, Jackson, TN 38305-2228 | 2020-06-01 |
| 1871088922 | Tate Enterprises, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1105 Laura Ave, Jackson, MS 39209-7008 | 2018-06-29 |
| 1609375781 | Advancing Opportunities, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 976 W Veterans Hwy, Jackson, NJ 08527-3337 | 2018-02-05 |
| 1841670775 | The Open Door of Nj | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 319 Sapphire Dr, Jackson, NJ 08527-1364 | 2015-06-05 |
| 1699155887 | Developmental Disabilities Association of Nj Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 609 Henry St, Jackson, NJ 08527-4650 | 2015-06-03 |
| 1982084075 | National Mentor Healthcare, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 880 Wright Debow Rd, Jackson, NJ 08527-5428 | 2015-06-03 |
| 1760861389 | The Arc Ocean County Chapter, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 76 Buckingham Dr, Jackson, NJ 08527-2640 | 2015-05-28 |
| 1588074116 | Morning Star Behavioral Associates LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 219 Quail Crk, Jackson, MO 63755-3810 | 2014-05-05 |
| 1174868707 | Household of Faith | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 341 Old Griffin Rd, Jackson, GA 30233-4952 | 2012-12-07 |
| 1053682724 | Center for Family Life Extension, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1160 Mclean St, Jackson, MS 39209-7251 | 2012-01-26 |
| Find all providers in JACKSON | ||||
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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.