| Edge Of Change, Llc | |
|
116 State St Ste 203 Augusta ME 04330-5632 | |
| (207) 592-9166 | |
| Not Available |
| Full Name | Edge Of Change, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 116 State St Ste 203, Augusta, Maine |
| Authorized Official Name and Position | Sara Fenwick (OWNER) |
| Authorized Official Contact | 2075929166 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edge Of Change, Llc 116 State St Ste 203 Augusta ME 04330-5632 Ph: (207) 592-9166 | Edge Of Change, Llc 116 State St Ste 203 Augusta ME 04330-5632 Ph: (207) 592-9166 |
| NPI Number | 1376269522 |
|---|---|
| Provider Enumeration Date | 10/18/2022 |
| Last Update Date | 10/18/2022 |
| Certification Date | 10/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376269522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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