Provider Demographics
NPI:1114144813
Name:ACADIA FAMILY CENTER
Entity Type:Organization
Organization Name:ACADIA FAMILY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MICHELE
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:MARKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-244-4012
Mailing Address - Street 1:PO BOX 807
Mailing Address - Street 2:
Mailing Address - City:SOUTHWEST HARBOR
Mailing Address - State:ME
Mailing Address - Zip Code:04679-0807
Mailing Address - Country:US
Mailing Address - Phone:207-244-4012
Mailing Address - Fax:207-244-4013
Practice Address - Street 1:1 FERNALD POINT RD
Practice Address - Street 2:
Practice Address - City:SOUTHWEST HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04679-4614
Practice Address - Country:US
Practice Address - Phone:207-244-4012
Practice Address - Fax:207-244-4013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME525239261QM0850X
ME219661261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
Not Answered261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME098152OtherANTHEM
ME=========OtherTRIVERIS
ME098152OtherANTHEM
ME=========OtherTEAMSTERS BEHAVIORAL HEAL
ME=========OtherAETNA