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NPI Code Detail

MEDICARE: TRI-COUNTY MENTAL HEALTH

MEDICARE: TRI-COUNTY MENTAL HEALTH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1364SP0808XPsychiatric/Mental Health Clinical Nurse SpecialistR050690ME

General Provider Information

NPI Number : 1629164082
Entity Type Code : Organization
Provider Name (Legal Business Name) : TRI-COUNTY MENTAL HEALTH
Provider Business Mailing Address
First Line : 49 WILLIAM ST APT 2
Second Line :
City : PORTLAND
State : ME
Zip : 04103-4882
Country : US
Telephone Number : 207-317-0471
Fax Number :
Provider Business Practice Location Address
First Line : 1155 LISBON ST
Second Line :
City : LEWISTON
State : ME
Zip : 04240-5025
Country : US
Telephone Number : 207-783-9141
Fax Number : 207-755-0045
Authorized Official
Title or Position : PATIENT ACCOUNTS MGR
Name : MR. DALE S. HUTCHINSON
Credential :
Telephone Number : 207-755-0036
Provider Enumeration Date : 10/05/2006
Last Update Date : 08/22/2020

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Directions to “TRI-COUNTY MENTAL HEALTH ” Practice Location

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