| Your Journey, Llc | |
|
92 Bennett Dr Ste 1 Caribou ME 04736-1952 | |
| (207) 493-5210 | |
| (207) 493-5209 |
| Full Name | Your Journey, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 92 Bennett Dr Ste 1, Caribou, Maine |
| Authorized Official Name and Position | Mary White (CEO) |
| Authorized Official Contact | 2074935210 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Your Journey, Llc 92 Bennett Dr Ste 1 Caribou ME 04736-1952 Ph: (207) 493-5210 | Your Journey, Llc 92 Bennett Dr Ste 1 Caribou ME 04736-1952 Ph: (207) 493-5210 |
| NPI Number | 1659723088 |
|---|---|
| Provider Enumeration Date | 07/11/2016 |
| Last Update Date | 12/19/2019 |
| Certification Date | 12/19/2019 |
| Medicare PECOS PAC ID | 1052692100 |
|---|---|
| Medicare Enrollment ID | O20170103001058 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659723088 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LC5672 (Maine) | Primary |
| Provider Name | Mary B White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245345065 PECOS PAC ID: 5991740623 Enrollment ID: I20050623000289 |
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