Provider Demographics
NPI:1467760256
Name:HEALTH AFFILIATES MAINE, LLC
Entity Type:Organization
Organization Name:HEALTH AFFILIATES MAINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:B
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:VI
Authorized Official - Credentials:
Authorized Official - Phone:207-777-4700
Mailing Address - Street 1:158 COURT ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-5907
Mailing Address - Country:US
Mailing Address - Phone:207-777-4700
Mailing Address - Fax:207-777-5566
Practice Address - Street 1:306 RODMAN RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-3830
Practice Address - Country:US
Practice Address - Phone:207-777-4700
Practice Address - Fax:207-777-5566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-15
Last Update Date:2010-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health