Provider Demographics
NPI:1932550324
Name:WESTERN MAINE BEHAVIORAL HEALTH, LLC
Entity Type:Organization
Organization Name:WESTERN MAINE BEHAVIORAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:POISSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-491-5995
Mailing Address - Street 1:284 MAIN ST STE 150
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:ME
Mailing Address - Zip Code:04294-3056
Mailing Address - Country:US
Mailing Address - Phone:207-645-2913
Mailing Address - Fax:207-645-2983
Practice Address - Street 1:284 MAIN ST STE 150
Practice Address - Street 2:
Practice Address - City:WILTON
Practice Address - State:ME
Practice Address - Zip Code:04294-3056
Practice Address - Country:US
Practice Address - Phone:207-645-2913
Practice Address - Fax:207-645-2983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health