Organization
MAINEHEALTH
Active
Other names
SPRING HARBOR COMMUNITY SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
LUGENE ANTHONY INZANA (ASSOCIATE CFO)
(207) 662-3538
Entity
Organization
Contact information
Practice address
12 UNION ST, ROCKLAND, ME 04841-2739
(207) 701-4400
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
Primary
680905
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132610000
—
ME
05
—
132610001
—
ME
05
—
132610002
—
ME
05
—
435657000
—
ME
05
—
435657001
—
ME
05
—
435657002
—
ME
05
—
435793100
—
ME
05
—
435793101
—
ME
Enumeration date
08/21/2018
Last updated
05/11/2020
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