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General NPI Number Information
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NPI Number | 1366138984
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Entity Type | Organization
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Legal Business Name | PEACE BEHAVIORAL HEALTH LLC
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Dates
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Enumeration Date | 04/17/2023
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 110 MAIN ST STE 1300D
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City | SACO
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State | ME
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Zip | 04072-3505
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Country | US
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Telephone | 207-200-4789
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Fax | 786-685-2120
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Provider Business Mailing Address
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Address Line | 110 MAIN ST STE 1300D
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City | SACO
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State | ME
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Zip | 04072-3505
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Country | US
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Telephone | 207-200-4789
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Fax | 786-685-2120
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICOLAS D SIKACZOWSKI
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Credential | DO
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Telephone | 305-600-3182
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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