Organization
MILESTONE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DOHERTY MSW (EXECUTIVE DIRECTOR)
(207) 775-4790
Entity
Organization
Contact information
Practice address
65 INDIA ST, PORTLAND, ME 04101-4209
(207) 775-4790
Mailing address
65 INDIA ST, PORTLAND, ME 04101-4209
(207) 775-4790
(207) 775-5231
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
238672
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137990001
—
ME
05
—
137990003
—
ME
Enumeration date
02/27/2007
Last updated
09/20/2023
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