Provider Demographics
NPI:1295078244
Name:HEALTHY FAMILY SERVICES OF MAINE INC.
Entity type:Organization
Organization Name:HEALTHY FAMILY SERVICES OF MAINE INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:GROSS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-622-5946
Mailing Address - Street 1:776 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:ME
Mailing Address - Zip Code:04330-8307
Mailing Address - Country:US
Mailing Address - Phone:207-622-5946
Mailing Address - Fax:207-622-4667
Practice Address - Street 1:776 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:ME
Practice Address - Zip Code:04330-8307
Practice Address - Country:US
Practice Address - Phone:207-622-5946
Practice Address - Fax:207-622-4667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health