Organization
PROVIDENCE SERVICE CORPORATION OF MAINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM BEATTIE LCSW (STATE EXECUTIVE DIRECTOR)
(207) 373-0620
Entity
Organization
Contact information
Practice address
14 MAINE ST, SUITE 202, BOX 50, BRUNSWICK, ME 04011-2049
(207) 373-0620
Mailing address
14 MAINE ST, SUITE 202, BOX 50, BRUNSWICK, ME 04011-2049
(207) 373-0620
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
392123
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
191700000
—
ME
Enumeration date
05/23/2012
Last updated
05/23/2012
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