Organization
STATE OF MAINE
Active
Organization
STATE OF MAINE
Active
Other names
Dorothea Dix Psychiatric Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL WEBB CODY (FINANCIAL MANAGER)
(207) 941-4192
Entity
Organization
Contact information
Practice address
656 STATE ST, BANGOR, ME 04401-5609
(207) 941-4192
Mailing address
109 CAPITOL STREET, STATE HOUSE STATION #11, REIMBURSEMENT UNIT, AUGUSTA, ME 04330-6846
(207) 287-7418
(207) 287-1862
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003288
BLUE CROSS
ME
05
—
135910900
—
ME
Enumeration date
08/09/2005
Last updated
06/17/2019
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