Organization
MAINE BEHAVIORAL HEALTHCARE
Active
Other names
Community Counseling Center
Organization subpart
No
Provider details
NPI number
Authorized official
GREG BOWERS (EVP & COO)
(207) 253-2629
Entity
Organization
Contact information
Practice address
165 LANCASTER ST, PORTLAND, ME 04101-2406
(207) 874-1030
(207) 874-1044
Mailing address
78 ATLANTIC PLACE, SOUTH PORTLAND, ME 04106-2316
(207) 842-7701
(207) 842-7773
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
680905
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104760000
—
ME
05
—
104760001
—
ME
05
—
104760100
—
ME
05
—
104760201
—
ME
05
—
14760200
—
ME
Enumeration date
07/20/2006
Last updated
06/16/2014
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