| Supportive Care Of Maine Llc | |
|
516 Mount Hope Ave Bangor ME 04401-4215 | |
| (718) 298-2753 | |
| Not Available |
| Full Name | Supportive Care Of Maine Llc |
|---|---|
| Speciality | Psychologist |
| Location | 516 Mount Hope Ave, Bangor, Maine |
| Authorized Official Name and Position | Raphael Lichtshcein (PRESIDENT) |
| Authorized Official Contact | 7182984375 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Supportive Care Of Maine Llc 27 Randolph Rd Howell NJ 07731-8611 Ph: (718) 298-4375 | Supportive Care Of Maine Llc 516 Mount Hope Ave Bangor ME 04401-4215 Ph: (718) 298-2753 |
| NPI Number | 1518681568 |
|---|---|
| Provider Enumeration Date | 10/03/2022 |
| Last Update Date | 10/03/2022 |
| Certification Date | 10/03/2022 |
| Medicare PECOS PAC ID | 3870959430 |
|---|---|
| Medicare Enrollment ID | O20230524001180 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518681568 | NPI | - | NPPES |
| Provider Name | Joseph C Drumm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619262680 PECOS PAC ID: 6305145020 Enrollment ID: I20230524001330 |
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