Organization
INTEGRATED BEHAVIORAL HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON CLARK M.D. (MEDICAL DIRECTOR)
(207) 761-4761
Entity
Organization
Contact information
Practice address
1 FOREST AVE, PORTLAND, ME 04101-2810
(207) 761-4761
(207) 780-1727
Mailing address
1 FOREST AVE, PORTLAND, ME 04101-2810
(207) 761-4761
(207) 780-1727
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
04/06/2006
Last updated
08/22/2020
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