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General NPI Number Information
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NPI Number | 1578911830
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Entity Type | Organization
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Legal Business Name | ACADIA HOSPITAL
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Dates
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Enumeration Date | 05/27/2016
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Last Update Date | 05/27/2016
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Provider Practice Location Address
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Address Line | 268 STILLWATER AVE
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City | BANGOR
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State | ME
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Zip | 04401-3945
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Country | US
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Telephone | 207-973-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 268 STILLWATER AVE
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City | BANGOR
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State | ME
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Zip | 04401-3945
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Country | US
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Telephone | 207-973-6100
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Fax |
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Authorized Official
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Title or Position | CLINICAL OPERATIONS SUPPORT SPECIAL
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Name | RHONDA WILLIAMS
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Credential | BS
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Telephone | 207-973-7530
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | LC14021
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License Number State | ME
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