Healthcare Provider Details

I. General information

NPI: 1275286668
Provider Name (Legal Business Name): SPRING HARBOR HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2022
Last Update Date: 01/27/2022
Certification Date: 01/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 ANDOVER RD
WESTBROOK ME
04092-3848
US

IV. Provider business mailing address

123 ANDOVER RD
WESTBROOK ME
04092-3848
US

V. Phone/Fax

Practice location:
  • Phone: 207-661-6252
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code283Q00000X
TaxonomyPsychiatric Hospital
License Number
License Number State

VIII. Authorized Official

Name: NICOLE MORGAN GRAHAM
Title or Position: OCCUPATIONAL THERAPIST
Credential: MS, OTR/L
Phone: 207-661-6252