LAKE GROVE MAPLE VALLEY (NPI# 1841468980) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841468980 |
| Entity Type | Organization |
| Organization Name | LAKE GROVE MAPLE VALLEY |
| Practice Address |
6 Farley Rd Wendell MA 01379-9706 |
| Mailing Address |
Po Box 786 Medford NY 11763-0786 |
| Practice Telephone | 9785446913 |
| Practice Fax Number | 9785448672 |
| Mailing Telephone | 6317162127 |
| Mailing Fax Number | 6317162135 |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2008-02-12 |
| Authorized Official Name | MR. FELIX WIENCLAW (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6316961400 |
| Is Organization Subpart | Y |
| Parent Organization Name | WINDWOOD MEADOW |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | Agencies | ||
| Y | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | Residential Treatment Facilities |
| Street Address |
6 FARLEY RD |
| City | WENDELL |
| State | MA |
| Zip Code | 01379-9706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417117169 | Jana R Lussier | Acupuncturist | 89 Jennison Rd, Wendell, MA 01379-7902 | 2008-06-16 |
| 1588894406 | Megan Mclean Hill | Midwife | 39 Bullard Rd, Wendell, MA 01379-7921 | 2009-07-27 |
| 1861532160 | Ilina M Singh | Registered Nurse | 74 West St, Wendell, MA 01379-9702 | 2007-02-07 |
| 1356760623 | Brian Anderson | Clinic/Center | 5 Morse Village Rd, Wendell, MA 01379-9704 | 2014-04-15 |
| 1073723805 | Virginia Elizabeth Schimmel | Registered Nurse | 55 Morse Village Rd, Wendell, MA 01379-9704 | 2007-05-23 |
| 1073925202 | Deb Tyler | Acupuncturist | 85 Bullard Pasture Rd, Wendell, MA 01379-9705 | 2014-05-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286338 | Dina Rose Velazquez | Marriage & Family Therapist | 500 Lemon Pepper Pl, Wendell, NC 27591-8948 | 2020-08-23 |
| 1801408810 | Rachel Kate Cockrell | Social Worker | 7204 Indian Rock Rd, Wendell, NC 27591-7643 | 2020-08-20 |
| 1063054872 | Monarch | Community/Behavioral Health | 1245 Hawks Perch Way, Wendell, NC 27591 | 2019-10-14 |
| 1821640558 | Hannah Nicole Roughgarden | Social Worker | 2424 Edgemont Rd, Wendell, NC 27591-8277 | 2019-07-12 |
| 1508420373 | K2red LLC | Pharmacy | 447 N Idaho St, Wendell, ID 83355 | 2019-04-27 |
| 1932665395 | Life Changing Counseling, LLC | Counselor | 3134 Wendell Blvd, Wendell, NC 27591-7271 | 2019-02-11 |
| 1164911996 | Orchard Home Care Agency | Home Infusion | 6412 Robertson Pond Rd, Wendell, NC 27591-9597 | 2018-05-07 |
| 1033612890 | Victoria Garvin | Behavior Technician | 1701 Chestnut Falls Rd, Wendell, NC 27591-6873 | 2018-03-16 |
| 1922500792 | New Stone Helath Group Inc | Nurse Practitioner | 7408 Seimans Dr, Wendell, NC 27591 | 2018-03-07 |
| 1326580689 | Intime Transportation Services LLC | Non-emergency Medical Transport (VAN) | 636 Convexa Ct, Wendell, NC 27591-6502 | 2016-11-17 |
| Find all providers in WENDELL | ||||
| Taxonomy Code | 322D00000X |
| Grouping | Residential Treatment Facilities |
| Classification | Residential Treatment Facility, Emotionally Disturbed Children |
| A provider facility or distinct part of the organization which renders an interdisciplinary program of mental health treatment to individuals under 21 years of age who have persistent dysfunction in major life areas. The dysfunction is of an extent and pervasiveness that requires a protected and highly structured therapeutic environment. These organizations, or distinct part of organizations, exclude those that provide acute psychiatric care, partial hospitalization, group living, therapeutic schooling, primary diagnosis substance abuse disorder treatment, or primary diagnosis mental retardation or developmental disability treatment. |
| Notes: Source: U.S. Department of Defense Regulation 6010.8-R, Chapter 6. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578128815 | Latham Centers, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 1646 Main St, Brewster, MA 02631-1716 | 2019-05-02 |
| 1104397488 | Hillcrest Educational Centers Inc | Residential Treatment Facility, Emotionally Disturbed Children | 5 Ramsdell Rd, Great Barrington, MA 01230-1147 | 2018-12-11 |
| 1851717458 | Hopewell Inc | Residential Treatment Facility, Emotionally Disturbed Children | 141 Low St, Newburyport, MA 01950-3539 | 2014-03-07 |
| 1740601400 | Northeast Center for Youth and Families | Residential Treatment Facility, Emotionally Disturbed Children | 201 East St, Easthampton, MA 01027-1234 | 2013-12-26 |
| 1033547500 | The Home for Little Wanderers | Residential Treatment Facility, Emotionally Disturbed Children | 910 Ship Pond Rd, Plymouth, MA 02360-1849 | 2013-10-21 |
| 1649546300 | Clinton Paul Pina IIi | Residential Treatment Facility, Emotionally Disturbed Children | 503 Rockdale Ave, New Bedford, MA 02740-1460 | 2012-03-28 |
| 1922267335 | Eagleton School Inc | Residential Treatment Facility, Emotionally Disturbed Children | 446 Monterey Road, Great Barrington, MA 01230 | 2008-06-02 |
| 1104027499 | Valleyhead, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 79 Reservoir Rd, Lenox, MA 01240-2008 | 2007-05-31 |
| 1295944353 | Protestant Guild for Human Services, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 411waverly Oaks Rd, Suite 104, Waltham, MA 02452-8468 | 2007-05-22 |
| 1144439977 | Robert F. Kennedy Children's Action Corps, Inc. | Residential Treatment Facility, Emotionally Disturbed Children | 220 Old Common Rd, Lancaster, MA 01523-2208 | 2007-05-21 |
| 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.