Organization
MAINEHEALTH
Active
Other names
MAINEHEALTH BEHAVIORAL HEALTH, Maine Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
LUGENE ANTHONY INZANA (SVP FINANCE, CFO)
(207) 662-2654
Entity
Organization
Contact information
Practice address
123 ANDOVER RD, WESTBROOK, ME 04092-3848
(207) 761-2200
Mailing address
78 ATLANTIC PL, SOUTH PORTLAND, ME 04106-2316
Taxonomy
Speciality
Code
Description
License number
State
283Q00000X
Psychiatric Hospital
Primary
37984
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
132600000
—
ME
Enumeration date
08/21/2018
Last updated
10/30/2024
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