| Food Addiction Chemical Dependency Consultants Llc | |
|
650 Main St Suite 103 So Portland ME 04106 | |
| (207) 774-4564 | |
| (207) 774-0006 |
| Full Name | Food Addiction Chemical Dependency Consultants Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 650 Main St, So Portland, Maine |
| Authorized Official Name and Position | Drusilla M Myers (PRESIDENT CEO) |
| Authorized Official Contact | 2077744564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Food Addiction Chemical Dependency Consultants Llc 650 Main St Suite 103 So Portland ME 04106 Ph: (207) 774-4564 | Food Addiction Chemical Dependency Consultants Llc 650 Main St Suite 103 So Portland ME 04106 Ph: (207) 774-4564 |
| NPI Number | 1881627958 |
|---|---|
| Provider Enumeration Date | 07/09/2006 |
| Last Update Date | 08/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881627958 | NPI | - | NPPES |
| 126240100 | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 22146 (Maine) | Primary |
| 101YM0800X | Counselor - Mental Health | 454002 (Maine) | Secondary |