Northern Lighthouse Inc. | |
14 Main St Mars Hill ME 04758 | |
(207) 425-3880 | |
Not Available |
Full Name | Northern Lighthouse Inc. |
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Speciality | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Location | 14 Main St, Mars Hill, Maine |
Authorized Official Name and Position | Scott Alan Cray (HUMAN RESOURCE ADMIN) |
Authorized Official Contact | 2075545114 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Northern Lighthouse Inc. Po Box 498 Mars Hill ME 04758-0498 Ph: (207) 425-3880 | Northern Lighthouse Inc. 14 Main St Mars Hill ME 04758 Ph: (207) 425-3880 |
NPI Number | 1831311968 |
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Provider Enumeration Date | 05/02/2007 |
Last Update Date | 02/04/2015 |
Medicare PECOS PAC ID | 2769611805 |
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Medicare Enrollment ID | O20141016000399 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831311968 | NPI | - | NPPES |
135580000 | Medicaid | ME | |
432482300 | Medicaid | ME | |
1355800001 | Medicaid | ME | |
135580100 | Medicaid | ME |
Provider Name | Christopher S Morse |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1083779672 PECOS PAC ID: 8921075631 Enrollment ID: I20040913000955 |
Provider Name | Theresa Flannery-blachura |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1154448785 PECOS PAC ID: 1153492004 Enrollment ID: I20080619000564 |
Provider Name | Angela M Burlock |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1417283375 PECOS PAC ID: 1951565084 Enrollment ID: I20120621000015 |
Provider Name | Jennifer M Crandall |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1073671046 PECOS PAC ID: 1153573209 Enrollment ID: I20121218000447 |