| Amistad, Inc. | |
|
103 India St Portland ME 04101-4211 | |
| (207) 773-1956 | |
| Not Available |
| Full Name | Amistad, Inc. |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 103 India St, Portland, Maine |
| Authorized Official Name and Position | Brian Townsend (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2077731956 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amistad, Inc. 103 India St Portland ME 04101-4211 Ph: (207) 773-1956 | Amistad, Inc. 103 India St Portland ME 04101-4211 Ph: (207) 773-1956 |
| NPI Number | 1982327805 |
|---|---|
| Provider Enumeration Date | 09/26/2022 |
| Last Update Date | 09/26/2022 |
| Certification Date | 09/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982327805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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