Organization
MILESTONE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. 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
28 PORTLAND ST, PORTLAND, ME 04101-1990
(207) 775-4790
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
238672
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137990000
—
ME
05
—
137990002
—
ME
Enumeration date
02/16/2007
Last updated
10/22/2023
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