Healthcare Provider Details

I. General information

NPI: 1215940523
Provider Name (Legal Business Name): ACADIA HOSPITAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 09/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

268 STILLWATER AVENUE
BANGOR ME
04401
US

IV. Provider business mailing address

PO BOX 422
BANGOR ME
04402-0422
US

V. Phone/Fax

Practice location:
  • Phone: 207-973-6470
  • Fax: 207-973-6109
Mailing address:
  • Phone: 207-973-6470
  • Fax: 207-973-6109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number36303
License Number StateME

VIII. Authorized Official

Name: DOROTHY E HILL
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 207-973-6100