Organization
MAINEHEALTH
Active
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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