Organization
STATE OF MAINE
Active
Other names
Dorothea Dix Psychiatric Center Out Patient Services
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL WEBB CODY (FINANCIAL MANAGER)
(207) 941-4192
Entity
Organization
Contact information
Practice address
656 STATE ST, BANGOR, ME 04401-5609
(207) 287-7418
(207) 287-1862
Mailing address
109 CAPITOL STREET SHS #11, REIMBURSEMENT UNIT, AUGUSTA, ME 04333-0011
(207) 287-7418
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
681294
ME
Other
Enumeration date
11/05/2014
Last updated
06/14/2019
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