Organization
MAINEHEALTH
Active
Other names
COUNSELING SERVICES, INC.
Organization subpart
No
Provider details
NPI number
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
2 SPRINGBROOK DR, BIDDEFORD, ME 04005-9443
(207) 282-1500
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
680905
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003086
ANTHEM BC/BS
ME
05
—
105330000
—
ME
01
—
1058005
CIGNA BEHAVIORAL HEALTH
ME
Enumeration date
08/21/2018
Last updated
05/11/2020
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