# BAYSIDE NEUROREHABILITATION SERVICES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Good Will Industries of New England
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881851517
- **Authorized official:** MS. ANN P COSTELLO LCSW (CLINICAL SOCIAL WORKER)
- **Authorized official phone:** (207) 761-8402

## Contact information

- **Practice address:** 26 PORTLAND ST, PORTLAND, ME 04101-2912
- **Practice address phone:** (207) 261-8402
- **Practice address fax:** (207) 271-8405
- **Mailing address:** 26 PORTLAND ST, PORTLAND, ME 04101-2912
- **Mailing address phone:** (207) 261-8402
- **Mailing address fax:** (207) 271-8405

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | LC9494 | ME | Yes |

## Other

- **Enumeration date:** 05/20/2008
- **Last updated:** 05/20/2008