Healthcare Provider Details

I. General information

NPI: 1578366530
Provider Name (Legal Business Name): ANEW BEHAVIORAL HEALTH OF MAINE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2025
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1132 US 1 STE 7 & 8
YORK ME
03909
US

IV. Provider business mailing address

11 KING CT
KEENE NH
03431-4649
US

V. Phone/Fax

Practice location:
  • Phone: 866-534-2639
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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 StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: KC MONTOYA
Title or Position: CONTRACT AND COMPLIANCE SPECIALIST
Credential:
Phone: 740-504-6846