Provider Demographics
NPI:1265268429
Name:TEMPLE STREAM PSYCHIATRIC SERVICES
Entity type:Organization
Organization Name:TEMPLE STREAM PSYCHIATRIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP
Authorized Official - Phone:207-578-6219
Mailing Address - Street 1:126 PERHAM ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04938-1524
Mailing Address - Country:US
Mailing Address - Phone:207-578-6219
Mailing Address - Fax:207-250-2386
Practice Address - Street 1:116 NARROW GAUGE SQ STE 101
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:ME
Practice Address - Zip Code:04938-5880
Practice Address - Country:US
Practice Address - Phone:207-578-6219
Practice Address - Fax:207-250-2386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-12
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty