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Organization

INGRAHAM

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHARLES MITCHELL M.D. (MEDICAL DIRECTOR)
(207) 874-1055
Entity
Organization

Contact information

Practice address
50 MONUMENT SQ, PORTLAND, ME 04101-4039
(207) 874-1055
(207) 775-4034
Mailing address
50 MONUMENT SQ, PORTLAND, ME 04101-4039
(207) 874-1055
(207) 775-4034

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LC10806
ME

Other

Enumeration date
01/25/2007
Last updated
08/22/2020
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