Healthcare Provider Details

I. General information

NPI: 1306769187
Provider Name (Legal Business Name): MACHIAS RIVER FAMILY PSYCHIATRYLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
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 STE 1
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 Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

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