Organization
MID-COAST MENTAL HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTHA MARCHUT LCSW (CLINICAL MANAGER)
(207) 701-4400
Entity
Organization
Contact information
Practice address
12 UNION ST, ROCKLAND, ME 04841-2739
(207) 701-4400
(207) 701-4486
Mailing address
12 UNION ST, ROCKLAND, ME 04841-2739
(207) 701-4400
(207) 701-4486
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
231141
ME
251S00000X
Community/Behavioral Health Agency
Primary
231141
ME
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
231141
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104000000
—
ME
05
—
104000001
—
ME
05
—
104000100
—
ME
05
—
104000101
—
ME
05
—
104000102
—
ME
05
—
104000200
—
ME
Enumeration date
09/21/2006
Last updated
12/04/2009
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