Provider Demographics
NPI:1437425212
Name:BLUE HILL PSYCHIATRIC SERVICES LLC
Entity Type:Organization
Organization Name:BLUE HILL PSYCHIATRIC SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAWALSKI
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:207-358-9320
Mailing Address - Street 1:PO BOX 809
Mailing Address - Street 2:
Mailing Address - City:BLUE HILL
Mailing Address - State:ME
Mailing Address - Zip Code:04614-0809
Mailing Address - Country:US
Mailing Address - Phone:207-358-9320
Mailing Address - Fax:207-358-3082
Practice Address - Street 1:6 MINES RD
Practice Address - Street 2:SUITE E2
Practice Address - City:BLUE HILL
Practice Address - State:ME
Practice Address - Zip Code:04614-6408
Practice Address - Country:US
Practice Address - Phone:207-358-9320
Practice Address - Fax:207-358-3082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81195251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health