MAINEHEALTH (NPI# 1265912067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265912067 |
| Entity Type | Organization |
| Organization Name | MAINEHEALTH |
| Other Organization Name | MAINE BEHAVIORAL HEALTHCARE |
| Practice Address |
165 Lancaster St Portland ME 04101-2406 |
| Mailing Address |
78 Atlantic Pl South Portland ME 04106-2316 |
| Practice Telephone | 2078741030 |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | LUGENE ANTHONY INZANA (ASSOCIATE CFO) |
| Authorized Official Telephone | 2076623538 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251S00000X | Community/Behavioral Health | 680905 | ME | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 104760201 | 05 | |
| ME | 104760000 | 05 | |
| ME | 104760100 | 05 | |
| ME | 104760001 | 05 | |
| ME | 14760200 | 05 |
| Other Name | Type Code |
|---|---|
| COMMUNITY COUNSELING CENTER | Doing Business As Name - Organization |
| Maine Behavioral Healthcare | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558841353 | Mainehealth | Skilled Nursing Facility | 35 July St, Sanford, ME 04073-1909 | 2018-08-21 |
| 1912304205 | Mainehealth | General Acute Care Hospital | 41 Spring Hill Rd, Saco, ME 04072-9650 | 2014-12-02 |
| 1831418128 | Mainehealth | Day Training, Developmentally Disabled Services | 39 Forest Ave, Portland, ME 04101 | 2010-05-26 |
| 1295800118 | Mainehealth | Clinic/Center | Cape Jellison Road, Stockton Springs, ME 04981 | 2006-11-24 |
| 1396815106 | Mainehealth | Pharmacy | Attn: Retail Pharmacy, 6 Glen Cove Drive, Rockport, ME 04856 | 2006-11-09 |
| 1528151065 | Mainehealth | Nursing Facility/Intermediate Care Facility | 145 Emery Lane, Boothbay Harbor, ME 04538 | 2006-10-02 |
| 1447342209 | Mainehealth | Skilled Nursing Facility | 35 July Street, Sanford, ME 04073 | 2006-09-29 |
| 1780788372 | Mainehealth | Internal Medicine | 19 West St, Portland, ME 04102 | 2006-09-12 |
| 1962496877 | Mainehealth | Skilled Nursing Facility | 6 White St, Rockland, ME 04841-2953 | 2005-09-07 |
| 1972129005 | Mainehealth | Clinic/Center | 123 Medical Center Dr, Brunswick, ME 04011-2652 | 2020-06-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MAINEHEALTH SERVICES | 110 Free St, Portland, ME 04101-3908 |
| Colorado Business Entities | MaineHealth, Inc. | 22 Bramhall Street, Portland, ME 04102 |
| Street Address |
165 LANCASTER ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-2406 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780646430 | Marianne Decain Tarraza | Registered Nurse | 165 Lancaster St, Portland, ME 04101-2406 | 2006-04-06 |
| 1033743232 | Glenn Andrew Mayer | Counselor | 165 Lancaster St, Portland, ME 04101-2406 | 2020-02-26 |
| 1972137172 | Erin Eileen Freysinger | Social Worker | 165 Lancaster St, Portland, ME 04101-2406 | 2020-02-26 |
| 1528603396 | Miranda Nichols | Counselor | 165 Lancaster St, Portland, ME 04101-2406 | 2019-11-15 |
| 1952889529 | Elizabeth Clifford | Nurse Practitioner | 165 Lancaster St, Portland, ME 04101 | 2018-08-05 |
| 1295222388 | Christine Renaud | Social Worker | 165 Lancaster St, Portland, ME 04101-2406 | 2018-04-16 |
| 1033627237 | Mackenzie Mullen Ross | Registered Nurse | 165 Lancaster St, Portland, ME 04101-2406 | 2018-01-22 |
| 1699282194 | Elizabeth Center | Counselor | 165 Lancaster St, Portland, ME 04101-2406 | 2018-01-05 |
| 1154794246 | Rebekah Joy Crabtree | Social Worker | 165 Lancaster St, Portland, ME 04101-2406 | 2015-11-11 |
| 1093198749 | Anthony C. Brucato | Counselor | 165 Lancaster St, Portland, ME 04101-2406 | 2015-06-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710586821 | Plum Consulting LLC | Community/Behavioral Health | 1161 Nw Overton St Apt 1501, Portland, OR 97209-2549 | 2020-10-20 |
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1184247850 | Altoris Behavior Support LLC | Community/Behavioral Health | 3880 Se 8th Ave Ste 105, Portland, OR 97202-3772 | 2020-05-28 |
| 1619599636 | Rivers Way Training Clinic | Community/Behavioral Health | 2049 Nw Hoyt, Portland, OR 97209 | 2020-05-13 |
| 1578102216 | Act Nw | Community/Behavioral Health | 909 Nw 24th Ave, Portland, OR 97210-3009 | 2019-12-28 |
| 1194284349 | Oriel Offit, Clinical Psychologist, LLC | Community/Behavioral Health | 222 Saint John St Ste 227, Portland, ME 04102-3058 | 2019-03-18 |
| 1396210977 | Ask Counseling LLC | Community/Behavioral Health | 8885 Sw Canyon Rd Ste 108, Portland, OR 97225-3431 | 2018-10-10 |
| 1790260313 | Bernard J. Gordon Md Pa LLC | Community/Behavioral Health | 145 Newbury St Fl 1, Portland, ME 04101-4261 | 2018-09-28 |
| 1497235576 | Saturn Supports LLC | Community/Behavioral Health | 3228 Sw Beaverton Hillsdale Hwy Apt 23, Portland, OR 97239-1193 | 2018-08-17 |
| 1770063067 | Nami Multnomah | Community/Behavioral Health | 524 Ne 52nd Ave, Portland, OR 97213-3047 | 2018-08-16 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.