Provider Demographics
NPI:1346556644
Name:DON ACORN SUBSTANCE ABUSE AND MENTAL HEALTH
Entity Type:Organization
Organization Name:DON ACORN SUBSTANCE ABUSE AND MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:ACORN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW LADC CCS
Authorized Official - Phone:207-578-1771
Mailing Address - Street 1:PO BOX 72
Mailing Address - Street 2:406 KIMBALL POND ROAD
Mailing Address - City:VIENNA
Mailing Address - State:ME
Mailing Address - Zip Code:04360-0072
Mailing Address - Country:US
Mailing Address - Phone:207-578-1771
Mailing Address - Fax:
Practice Address - Street 1:32 COLLEGE AVE
Practice Address - Street 2:SUITE 206
Practice Address - City:WATERVILLE
Practice Address - State:ME
Practice Address - Zip Code:04901-6100
Practice Address - Country:US
Practice Address - Phone:207-578-1771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-24
Last Update Date:2010-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC 7773251S00000X
MELC2309251S00000X
MECCS3211251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME11537926OtherCAQH
ME1750315750Medicare PIN