Healthcare Provider Details

I. General information

NPI: 1073436408
Provider Name (Legal Business Name): MACHIAS RIVER FAMILY PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

49 OAK ST STE 1
AUGUSTA ME
04330-5118
US

IV. Provider business mailing address

49 OAK ST
AUGUSTA ME
04330-5118
US

V. Phone/Fax

Practice location:
  • Phone: 207-829-5533
  • Fax: 207-481-4106
Mailing address:
  • Phone: 207-829-5533
  • Fax: 207-481-4106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JOHANNA HILTZ
Title or Position: PRESIDENT
Credential:
Phone: 207-829-5533