St Croix Regional Family Health Center | |
136 Mill St Princeton ME 04668-3344 | |
(207) 796-5503 | |
(207) 796-5528 |
Full Name | St Croix Regional Family Health Center |
---|---|
Speciality | Clinic/Center |
Location | 136 Mill St, Princeton, Maine |
Authorized Official Name and Position | Corinne A Laplant (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 2077965503 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
St Croix Regional Family Health Center 136 Mill St Princeton ME 04668-3344 Ph: (207) 796-5503 | St Croix Regional Family Health Center 136 Mill St Princeton ME 04668-3344 Ph: (207) 796-5503 |
NPI Number | 1831174614 |
---|---|
Provider Enumeration Date | 12/14/2005 |
Last Update Date | 11/20/2012 |
Medicare PECOS PAC ID | 3577524024 |
---|---|
Medicare Enrollment ID | O20041019000977 |
Identifier | Type | State | Issuer |
---|---|---|---|
1831174614 | NPI | - | NPPES |
123350000 | Medicaid | ME |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Provider Name | Christine A White |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1336124114 PECOS PAC ID: 8527043371 Enrollment ID: I20040624000143 |
Provider Name | Lawrence Crystal |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1508814450 PECOS PAC ID: 0840253001 Enrollment ID: I20041109000198 |
Provider Name | Mark D Kaplan |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1861498461 PECOS PAC ID: 3173580503 Enrollment ID: I20041216000668 |
Provider Name | Tara C L Dwelley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1780649137 PECOS PAC ID: 8022043090 Enrollment ID: I20050928000743 |
Provider Name | Sally A Johnson |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457336224 PECOS PAC ID: 7214951730 Enrollment ID: I20070627000223 |
Provider Name | Janice S Small |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457724148 PECOS PAC ID: 5890096796 Enrollment ID: I20151218000796 |
Provider Name | Phylicia J Bonavida |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710456439 PECOS PAC ID: 4183960081 Enrollment ID: I20190115000485 |
Provider Name | Alaina M. Willson |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1487952271 PECOS PAC ID: 1658600861 Enrollment ID: I20190913001548 |
Provider Name | Brittany J Voisine |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760131510 PECOS PAC ID: 0547657819 Enrollment ID: I20220505001024 |
Provider Name | Michael A Swope |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1184326787 PECOS PAC ID: 6800261579 Enrollment ID: I20230411001448 |
Provider Name | Yazhou Zhang |
---|---|
Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1801241518 PECOS PAC ID: 2567737349 Enrollment ID: I20230906003629 |
Provider Name | Ernesto Cantu |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1164837605 PECOS PAC ID: 5890096606 Enrollment ID: I20231004001891 |
Provider Name | Marisol Rivera |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1043417058 PECOS PAC ID: 4789961178 Enrollment ID: I20231209000048 |
Passamaquoddy Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 Peter Dana Point Road, Princeton, ME 04668 Phone: 207-796-2321 Fax: 207-796-2422 |