| Avalon Services LLC | |
|
37 Park St Ste 302 Lewiston ME 04240-7195 | |
| (207) 333-1080 | |
| (207) 777-4649 |
| Full Name | Avalon Services LLC |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 37 Park St Ste 302, Lewiston, Maine |
| Authorized Official Name and Position | Blaine Linton (OWNER) |
| Authorized Official Contact | 2074024890 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avalon Services LLC 37 Park St Ste 302 Lewiston ME 04240-7195 Ph: (207) 333-1080 | Avalon Services LLC 37 Park St Ste 302 Lewiston ME 04240-7195 Ph: (207) 333-1080 |
| NPI Number | 1659923068 |
|---|---|
| Provider Enumeration Date | 07/15/2019 |
| Last Update Date | 02/06/2020 |
| Certification Date | 02/06/2020 |
| Medicare PECOS PAC ID | 2466936380 |
|---|---|
| Medicare Enrollment ID | O20260319000109 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659923068 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | () | Secondary |
| 251S00000X | Community/behavioral Health | () | Primary |
| Provider Name | Kristina Julia Beladi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376073163 PECOS PAC ID: 0345513164 Enrollment ID: I20170830000994 |
| Provider Name | Meagan Erin Mcdougal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316708852 PECOS PAC ID: 2264916105 Enrollment ID: I20260319000573 |
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