Organization
MOVING FORWARD MENTAL HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M GRINDLE (OWNER)
(207) 208-8301
Entity
Organization
Contact information
Practice address
61 MAIN ST STE 53, BANGOR, ME 04401-6333
(207) 208-8301
Mailing address
61 MAIN ST STE 53, BANGOR, ME 04401-6333
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP081803
ME
Other
Enumeration date
12/22/2011
Last updated
12/22/2011
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