| Goodwill Industries Of Northern New England | |
|
75 Washington Avenue Suite 300 Portland ME 04101 | |
| (207) 774-6323 | |
| (207) 761-8460 |
| Full Name | Goodwill Industries Of Northern New England |
|---|---|
| Speciality | Clinic/Center |
| Location | 75 Washington Avenue, Portland, Maine |
| Authorized Official Name and Position | Sharlene Adams (SENIOR DIRECTOR, CLINICAL SVC) |
| Authorized Official Contact | 2077956110 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goodwill Industries Of Northern New England 75 Washington Avenue Suit 300 Portland ME 04101 Ph: (207) 774-6323 | Goodwill Industries Of Northern New England 75 Washington Avenue Suite 300 Portland ME 04101 Ph: (207) 774-6323 |
| NPI Number | 1588785463 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 07/22/2014 |
| Medicare PECOS PAC ID | 7911961032 |
|---|---|
| Medicare Enrollment ID | O20041119000381 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588785463 | NPI | - | NPPES |
| 104490002 | Medicaid | ME | |
| 104490100 | Medicaid | ME | |
| 104490300 | Medicaid | ME | |
| 104490303 | Medicaid | ME | |
| 104490000 | Medicaid | ME | |
| 104490200 | Medicaid | ME | |
| 104490001 | Medicaid | ME | |
| 104490301 | Medicaid | ME | |
| 104490201 | Medicaid | ME | |
| 104490302 | Medicaid | ME |
| Provider Name | Stephen Raymond Small |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780891481 PECOS PAC ID: 6002845476 Enrollment ID: I20050805000422 |
Soul Sanctuary, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1519 Forest Ave, Portland, ME 04103 Phone: 617-690-9020 | |
Catholic Charities Maine Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 307 Congress Street, Portland, ME 04101 Phone: 207-781-8550 Fax: 207-781-8560 | |
Learningworks Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 181 Brackett St, Portland, ME 04102 Phone: 207-775-0105 Fax: 207-775-1392 | |
Dani Fazio Psychotherapy Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 57 Exchange St Ste 203, Portland, ME 04101 Phone: 207-618-6588 Fax: 207-203-6480 | |
Ingraham Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 50 Monument Sq, Portland, ME 04101 Phone: 207-874-1055 Fax: 207-774-5901 | |
Alliance Residential Care, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 58 Boyd St Apt 501, Portland, ME 04101 Phone: 860-710-6770 | |
First Light Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1520 Westbrook St, Portland, ME 04102 Phone: 207-776-8442 |