Organization
COASTAL BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL GRAZIA LCSW (CO-OWNER)
(203) 671-3788
Entity
Organization
Contact information
Practice address
175 LANCASTER ST STE 218A, PORTLAND, ME 04101-2451
(203) 671-3788
Mailing address
175 LANCASTER ST STE 218A, PORTLAND, ME 04101-2451
(203) 671-3788
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
LC15872
ME
251S00000X
Community/Behavioral Health Agency
Primary
LC15872
ME
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
LC15872
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669850376
—
ME
05
—
1992162390
—
ME
Enumeration date
06/15/2018
Last updated
06/15/2018
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