|
| |
|
222 Saint John St Suite 233 Portland ME 04102-3041 | |
| (207) 772-1698 | |
| (207) 347-8089 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 222 Saint John St, Portland, Maine |
| Authorized Official Name and Position | James B Hurd (DIRECTOR) |
| Authorized Official Contact | 2077721698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
222 Saint John St Suite 233 Portland ME 04102-3041 Ph: (207) 772-1698 | 222 Saint John St Suite 233 Portland ME 04102-3041 Ph: (207) 772-1698 |
| NPI Number | 1932349107 |
|---|---|
| Provider Enumeration Date | 03/02/2009 |
| Last Update Date | 03/02/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932349107 | NPI | - | NPPES |
| 109270100 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Soul Sanctuary, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1519 Forest Ave, Portland, ME 04103 Phone: 617-690-9020 | |
Catholic Charities Maine Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 307 Congress Street, Portland, ME 04101 Phone: 207-781-8550 Fax: 207-781-8560 | |
Dani Fazio Psychotherapy Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 57 Exchange St Ste 203, Portland, ME 04101 Phone: 207-618-6588 Fax: 207-203-6480 | |
Ingraham Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Monument Sq, Portland, ME 04101 Phone: 207-874-1055 Fax: 207-774-5901 | |
Alliance Residential Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 58 Boyd St Apt 501, Portland, ME 04101 Phone: 860-710-6770 | |
Lauren Grousd Lcpc Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 440 Forest Ave, Portland, ME 04101 Phone: 207-650-8906 Fax: 207-221-2130 |