Organization
MAINE MATERNAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MALLORY ZWERDLING MS (OWNER)
(207) 479-7841
Entity
Organization
Contact information
Practice address
52 BOLTON ST, PORTLAND, ME 04102-2502
(207) 479-7841
Mailing address
52 BOLTON ST, PORTLAND, ME 04102-2502
(207) 479-7841
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
07/25/2019
Last updated
01/31/2020
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