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 |
