| Providence Service Corporation Of Maine | |
|
14 Maine St Suite 202, Box 50 Brunswick ME 04011-2049 | |
| (207) 373-0620 | |
| Not Available |
| Full Name | Providence Service Corporation Of Maine |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 14 Maine St, Brunswick, Maine |
| Authorized Official Name and Position | William Beattie (STATE EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2073730620 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Service Corporation Of Maine 14 Maine St Suite 202, Box 50 Brunswick ME 04011-2049 Ph: (207) 373-0620 | Providence Service Corporation Of Maine 14 Maine St Suite 202, Box 50 Brunswick ME 04011-2049 Ph: (207) 373-0620 |
| NPI Number | 1629338769 |
|---|---|
| Provider Enumeration Date | 05/23/2012 |
| Last Update Date | 05/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629338769 | NPI | - | NPPES |
| 191700000 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 392123 (Maine) | Primary |
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