Healthcare Provider Details

I. General information

NPI: 1598177289
Provider Name (Legal Business Name): PARAMOUNT BEHAVIORAL SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 03/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 ELM ST
WATERVILLE ME
04901-6017
US

IV. Provider business mailing address

58 ELM ST
WATERVILLE ME
04901-6017
US

V. Phone/Fax

Practice location:
  • Phone: 207-660-9124
  • Fax:
Mailing address:
  • Phone: 207-660-9124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: REBECCA DUNLAP
Title or Position: PRESIDENT
Credential:
Phone: 207-660-9124