| 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 | O20041117000895 |
| 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 | Meridyth R Astrosky |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376734665 PECOS PAC ID: 4486618345 Enrollment ID: I20041119000206 |
| Provider Name | Jill A Welch |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326269432 PECOS PAC ID: 8820198070 Enrollment ID: I20070717000463 |
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