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General NPI Number Information
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NPI Number | 1437425212
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Entity Type | Organization
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Legal Business Name | BLUE HILL PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 6 MINES RD SUITE E2
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City | BLUE HILL
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State | ME
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Zip | 04614-6408
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Country | US
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Telephone | 207-358-9320
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Fax | 207-358-3082
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Provider Business Mailing Address
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Address Line | PO BOX 809
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City | BLUE HILL
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State | ME
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Zip | 04614-0809
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Country | US
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Telephone | 207-358-9320
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Fax | 207-358-3082
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Authorized Official
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Title or Position | OWNER OPERATOR
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Name | LISA ZAWALSKI
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Credential | NP
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Telephone | 207-358-9320
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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 | CNP81195
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License Number State | ME
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