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General NPI Number Information
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NPI Number | 1205974086
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Entity Type | Organization
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Legal Business Name | PATHWAYS OF MAINE, INC.
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 71 US ROUTE 1 SUITE H
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City | SCARBOROUGH
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State | ME
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Zip | 04074-7173
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Country | US
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Telephone | 207-373-0620
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Fax | 207-373-0628
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Provider Business Mailing Address
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Address Line | 10304 SPOTSYLVANIA AVE 3RD FLOOR
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City | FREDERICKSBURG
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State | VA
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Zip | 22408-8602
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Country | US
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Telephone | 540-710-2800
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Fax | 540-710-7447
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MS. NICOLE T ZENGA
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Credential |
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Telephone | 207-373-0620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 392123
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License Number State | ME
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