Provider Demographics
NPI: | 1487601399 |
---|---|
Name: | AROOSTOOK MENTAL HEALTH SERVICES, INC. |
Entity type: | Organization |
Organization Name: | AROOSTOOK MENTAL HEALTH SERVICES, INC. |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ELLEN |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | BEMIS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 207-554-2352 |
Mailing Address - Street 1: | 180 ACADEMY ST STE 3 |
Mailing Address - Street 2: | |
Mailing Address - City: | PRESQUE ISLE |
Mailing Address - State: | ME |
Mailing Address - Zip Code: | 04769-3183 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 207-554-2352 |
Mailing Address - Fax: | 207-554-2351 |
Practice Address - Street 1: | 180 ACADEMY ST STE 2 |
Practice Address - Street 2: | |
Practice Address - City: | PRESQUE ISLE |
Practice Address - State: | ME |
Practice Address - Zip Code: | 04769-3183 |
Practice Address - Country: | US |
Practice Address - Phone: | 207-764-3319 |
Practice Address - Fax: | 207-768-5377 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-05-27 |
Last Update Date: | 2025-01-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
101Y00000X, 103T00000X, 103TC0700X, 104100000X, 1041C0700X, 2084P0800X, 251B00000X, 324500000X, 363A00000X, 363LP0808X, 261QM0801X | ||
ME | 219601 | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
No | 101Y00000X | Behavioral Health & Social Service Providers | Counselor | Group - Multi-Specialty | |
No | 103T00000X | Behavioral Health & Social Service Providers | Psychologist | Group - Multi-Specialty | |
No | 103TC0700X | Behavioral Health & Social Service Providers | Psychologist | Clinical | Group - Multi-Specialty |
No | 104100000X | Behavioral Health & Social Service Providers | Social Worker | Group - Multi-Specialty | |
No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
No | 251S00000X | Agencies | Community/Behavioral Health | Group - Multi-Specialty | |
No | 324500000X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Group - Multi-Specialty | |
No | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Group - Multi-Specialty | |
No | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
ME | 103850000 | Other | MAINECARE |
ME | 1487601399 | Medicaid | |
ME | MM3781 | Medicare PIN |