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Organization

FACING CHANGE, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. BETSY A. GREENLAW C.A.D.C. (COUNSELOR)
(207) 784-0922
Entity
Organization

Contact information

Practice address
4 PARK ST, LEWISTON, ME 04240-7172
(207) 784-0922
(207) 784-6143
Mailing address
4 PARK ST, LEWISTON, ME 04240-7172
(207) 784-0922
(207) 784-6143

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
CAC4790
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
129500000
ME
Enumeration date
12/09/2010
Last updated
12/09/2010
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