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CORNERSTONE BEHAVIORAL HEALTHCARE LLC NPI 1215102850


NPI Information

NPI: 1215102850
Provider Name: CORNERSTONE BEHAVIORAL HEALTHCARE, LLC
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization

CLIA Number: 20D2168698

Address:
157 PARK STREET
SUITE 5
BANGOR, ME
ZIP 04401
Phone: (207) 992-0410
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CORNERSTONE BEHAVIORAL HEALTHCARE, LLC is a community behavioral health in Bangor, ME. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. CORNERSTONE BEHAVIORAL HEALTHCARE, LLC NPI is 1215102850. The provider is registered as an organization entity type.

The provider's business location address is:

157 PARK STREET
SUITE 5
BANGOR, ME
ZIP 04401-000
Phone: (207) 992-0410
Fax: (207) 992-0414

The provider's authorized official is Frank H Willard .
The authorized official title is Member, Ceo and has the following contact phone number (207) 992-0410.

The CLIA number assigned to this NPI record is 20D2168698 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/24/2008 and was last updated on 12/14/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral Health569364MAINEYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1432911500MEDICAIDMAINE
2008026MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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