MANNA INC (NPI# 1760497200) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760497200 |
| Entity Type | Organization |
| Organization Name | MANNA INC |
| Practice Address |
629 Main St Bangor ME 04401-6848 |
| Mailing Address |
Po Box 2763 Bangor ME 04402-2763 |
| Practice Telephone | 2079902870 |
| Practice Fax Number | 2079902298 |
| Mailing Telephone | 2079902870 |
| Mailing Fax Number | 2079902298 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARK RAE (DIRECTOR OF OPERATIONS) |
| Authorized Official Telephone | 2079902870 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities | ||
| X | 324500000X | Substance Abuse Rehabilitation Facility | 453264 | ME | Residential Treatment Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275660979 | Manna Inc | Social Worker | 629 Main Street, Bangor, ME 04401 | 2007-02-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | MANNA INC | 1992 Brewer Ave, Eugene, OR 97401 |
| Indiana Business Entities | MANNA INC. | 1818 E. Co. Rd. 750 S., Versailles, IN 47042 |
| Street Address |
629 MAIN ST |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-6848 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588647838 | David E.a. Presutte | Counselor | 629 Main St, Bangor, ME 04401-6848 | 2005-11-21 |
| 1104267954 | Ronda Anderson | Counselor | 629 Main St, Bangor, ME 04401-6848 | 2013-07-09 |
| 1205273786 | Manna Inc. | Substance Abuse Rehabilitation Facility | 629 Main St, Bangor, ME 04401-6848 | 2013-05-24 |
| 1649614728 | Manna Inc. | Community/Behavioral Health | 629 Main St, Bangor, ME 04401-6848 | 2013-04-19 |
| 1437442894 | Holly Ann Merchant | Counselor | 629 Main St, Bangor, ME 04401-6848 | 2011-05-18 |
| 1780986315 | Jeremy Matthew Crockett | Counselor | 629 Main St, Bangor, ME 04401-6848 | 2010-12-02 |
| 1316255706 | Casey E Harris | Counselor | 629 Main St, Bangor, ME 04401-6848 | 2010-09-20 |
| 1568786499 | Amy Richard | Counselor | 629 Main St, Bangor, ME 04401-6848 | 2010-03-22 |
| 1760665251 | Ardis L White | Counselor | 629 Main St, Bangor, ME 04401-6878 | 2007-12-07 |
| 1699962258 | Aimee Michelle Cyr | Counselor | 629 Main St, Bangor, ME 04401-6878 | 2007-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881831329 | Wings for Children and Families Inc. | Clinic/Center | 900 Hammond St, Suite 915, Bangor, ME 04401-4378 | 2009-01-20 |
| 1871847103 | Restoration Health LLC | Clinic/Center | 1 Cumberland Pl, Suite 114, Bangor, ME 04401-5083 | 2012-11-08 |
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|---|---|---|---|---|
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| 1326682774 | New Hope Residential Care | Clinic/Center | 43 Rollins Way, South Portland, ME 04106-1942 | 2019-10-29 |
| 1821654112 | Hand of Mercy Health Care, LLC | Clinic/Center | 1087 Forest Ave, Portland, ME 04103-3321 | 2019-05-13 |
| 1700358314 | Nikki Wetherell Counseling | Clinic/Center | 19 South St Ste 6, Portland, ME 04101-3963 | 2018-12-20 |
| 1952870792 | Psychwellness, LLC | Clinic/Center | 169 Park Row Ste 6, Brunswick, ME 04011-2039 | 2018-11-23 |
| 1255846531 | Mid-coast Family Wellness Center, LLC | Clinic/Center | 219 Route One Ste 101, Edgecomb, ME 04556-3000 | 2017-12-07 |
| 1073037099 | Next Step Domestic Violence Project | Clinic/Center | 733 Bangor Rd, Ellsworth, ME 04605-3580 | 2017-08-01 |
| 1306170295 | Department of Veterans Affairs | Clinic/Center | 99 River Rd, Lincoln, ME 04457-4012 | 2009-09-24 |
| 1891733309 | Maine Behavioral Healthcare | Clinic/Center | 2 Springbrook Dr, Biddeford, ME 04005-9443 | 2006-06-04 |
| 1538122445 | Sweetser | Clinic/Center | 50 Moody Street, Saco, ME 04072 | 2006-04-11 |
| Find all providers with the same taxonomy | ||||
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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.