| Organization Name: | PINETREE BEHAVIORAL HEALTH, LLC |
| NPI Number: | 1003224726 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTOPHER GARRISON (OWNER/LCPC) |
| Mailing Address: | 263 State St Ste 9 Bangor |
| State: | ME US |
| Postal Code: | 044015461 |
| Phone Number: | 2073077119 |
| Fax Number: | 2073077129 |
| NPI Enumeration Date: | 07/25/2014 |
| NPI Last Update Date: | 07/25/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | CC1731 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |