Basic Information
| Provider Information | |||||||||
| NPI: | 1568477297 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACADIA HEALTHCARE, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 442 | ||||||||
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| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 044020422 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079736100 | ||||||||
| FaxNumber: | 2079736109 | ||||||||
| Practice Location | |||||||||
| Address1: | 268 STILLWATER AVENUE | ||||||||
| Address2: | |||||||||
| City: | BANGOR | ||||||||
| State: | ME | ||||||||
| PostalCode: | 04401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2079736100 | ||||||||
| FaxNumber: | 2079736109 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/30/2006 | ||||||||
| LastUpdateDate: | 01/03/2018 | ||||||||
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| AuthorizedOfficialLastName: | SUITTER | ||||||||
| AuthorizedOfficialFirstName: | MARIE | ||||||||
| AuthorizedOfficialMiddleName: | K | ||||||||
| AuthorizedOfficialTitleorPosition: | VP OF FINANCE AND OPERATIONS | ||||||||
| AuthorizedOfficialTelephone: | 2079735110 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM2800X | ME | N | Ambulatory Health Care Facilities | Clinic/Center | Methadone Clinic | 324500000X | ARC 231302 | ME | N | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | 261QM0801X | ME | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
ID Information
| ID | Type | State | Issuer | Description | 1568477297 | 05 | ME | MEDICAID |