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93 Campus Avenue Lewiston ME 04240-6030 | |
| (207) 777-8100 | |
| (207) 777-8800 |
| Full Name | |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 93 Campus Avenue, Lewiston, Maine |
| Authorized Official Name and Position | Donald H Bevers (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2077778865 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 95000 Lbx 7650 Philadelphia PA 19195-0001 Ph: () - | 93 Campus Avenue Lewiston ME 04240-6030 Ph: (207) 777-8100 |
| NPI Number | 1245292788 |
|---|---|
| Provider Enumeration Date | 04/03/2006 |
| Last Update Date | 11/14/2022 |
| Certification Date | 11/14/2022 |
| Medicare PECOS PAC ID | 0042107120 |
|---|---|
| Medicare Enrollment ID | O20111117000231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245292788 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 38244 (Maine) | Secondary |
| 273R00000X | Psychiatric Unit | (* (Not Available)) | Primary |
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