# INDEPENDENCE PROJECT LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073751277
- **Authorized official:** MR. DAVID EDWARD PELKEY LADC (ADMINISTRATOR/MEMBER/OWNER)
- **Authorized official phone:** (207) 945-9777

## Contact information

- **Practice address:** 96 HARLOW ST, SUITE 340, BANGOR, ME 04401-4925
- **Practice address phone:** (207) 945-9777
- **Practice address fax:** (207) 945-9777
- **Mailing address:** 96 HARLOW ST, SUITE 340, BANGOR, ME 04401-4925
- **Mailing address phone:** (207) 945-9777
- **Mailing address fax:** (207) 945-9777

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 467117 | ME | Yes |

## Other

- **Enumeration date:** 01/26/2009
- **Last updated:** 01/27/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 431482300 | — | ME |