ST JUDE'S FOSTER HOME – NPI #1114168945
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

Health Care Provider Taxonomy Code for Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

ST JUDE'S FOSTER HOME is a community based residential treatment facility located in VAN BUREN, ME. NPPES has assigned the NPI number 1114168945 to ST JUDE'S FOSTER HOME on March 06, 2009. It is a Type-2 NPI, indicating this NPI number is associated with an organization. ST JUDE'S FOSTER HOME is also known by the name JUDY GAGNON. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for ST JUDE'S FOSTER HOME below.

NPI Profile for
ST JUDE'S FOSTER HOME

NPI Number
1114168945
Enumeration Date

(more than 17 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
ST JUDE'S FOSTER HOME
Other Name: JUDY GAGNON
Primary location
123 WRIGHT STREET
VAN BUREN, ME 04785
Phone: (207) 868-5180 Fax: (207) 868-7781
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JUDY GAGNON
FOSTER HOME OPERATOR
Phone: (207) 868-5180
Updated
Identifiers

Identifiers for ST JUDE'S FOSTER HOME

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDME197470000
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.