# STONYBROOK MENTAL HEALTH

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811480452
- **Authorized official:** MR. RICHARD G COREY (OWNER)
- **Authorized official phone:** (207) 664-8529

## Contact information

- **Practice address:** 875 HAMMOND ST, BANGOR, ME 04401-4303
- **Practice address phone:** (207) 664-8529
- **Mailing address:** PO BOX 72, HOLDEN, ME 04429-0072
- **Mailing address phone:** (207) 664-8529

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251B00000X | Case Management Agency | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | Yes |
| 320900000X | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | — | NULL | — |

## Other

- **Enumeration date:** 06/08/2018
- **Last updated:** 06/08/2018