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Organization

NEW LIFE MISSION

Active
Other names
BANGOR COUNSELING CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LORNA M LYONS (ADMINISTRATIVE SUPERVISOR)
(207) 941-6434
Entity
Organization

Contact information

Practice address
202 EXCHANGE ST, BANGOR, ME 04401-6508
(207) 941-6434
(207) 941-9366
Mailing address
202 EXCHANGE ST, BANGOR, ME 04401-6508
(207) 941-6434
(207) 941-9366

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
392936
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
121150001
ME
05
121150100
ME
Enumeration date
02/09/2007
Last updated
10/29/2009
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