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KATAHDIN NURSING HOME
NPI 1366431033
Nursing Facility/Intermediate Care Facility in Millinocket, ME

Active since October 17, 2005CLIA 20D0089627 · Waiver
22 WALNUT ST, MILLINOCKET, ME 04462(207) 723-4711(207) 723-6704 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Katahdin Nursing Home NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KATAHDIN NURSING HOME (NPI 1366431033) is a healthcare organization registered as a nursing facility/intermediate care facility in Millinocket, Maine and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through April 10, 2028 and lists Marlene E. Campbell, Adminstrator, as its authorized official.

NPPES Registry Identity

NPI1366431033
Entity TypeOrganization
Primary Taxonomy313M00000X
Legal Business NameKATAHDIN NURSING HOME
Location Address22 WALNUT STMillinocket, ME 04462-2128
Mailing Address22 Walnut StMillinocket, ME 04462-2128 · (207) 723-4711 · Fax (207) 723-6704
Phone(207) 723-4711
Fax(207) 723-6704
Organization SubpartNo
Authorized OfficialMarlene E. CampbellAdminstrator · (207) 723-4711
Enumeration DateOctober 17, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1366431033 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNursing Facility/Intermediate Care FacilityNursing & Custodial Care Facilities
Taxonomy Code313M00000X
License✔ Licensed in ME · 36319
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
22 WALNUT ST, Millinocket, ME 04462
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D0089627

Katahdin Nursing Home · Millinocket, ME
Active · expires Apr 10, 2028
CLIA Number20D0089627
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 11, 2026
Certificate Expiration DateApril 10, 2028
Laboratory DirectorToni Tibbitts
Laboratory Phone(207) 723-4711
Laboratory LocationKatahdin Nursing Home22 Walnut Street Attn Toni Tibbitts, Millinocket, ME 04462
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KATAHDIN HEALTH CARE LLC
Skilled Nursing Facility
22 WALNUT ST
MILLINOCKET, ME 04462
Penobscot County (207) 723-4711
CAITLIN JILL MORSE
Occupational Therapy Assistant
22 WALNUT ST
MILLINOCKET, ME 04462
Penobscot County (207) 723-4711

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Katahdin Nursing Home's NPI number?

The NPI number for Katahdin Nursing Home is 1366431033. It was assigned to this organization in the NPPES registry on October 17, 2005.

Where is Katahdin Nursing Home located?

Katahdin Nursing Home is located at 22 Walnut St, Millinocket, ME 04462. The listed phone number is (207) 723-4711.

What is Katahdin Nursing Home's specialty?

The primary specialty registered for this NPI is Nursing Facility/Intermediate Care Facility with taxonomy code 313M00000X.

Does Katahdin Nursing Home hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D0089627) is associated with this NPI, valid through April 10, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Katahdin Nursing Home was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.