Organization
NORTHEAST WELLNESS GROUP, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH RILEY (CEO)
(774) 269-4700
Entity
Organization
Contact information
Practice address
449 FOREST AVE STE 14, PORTLAND, ME 04101-2037
(774) 269-4700
Mailing address
449 FOREST AVE STE 14, PORTLAND, ME 04101-2037
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
Primary
—
—
Other
Enumeration date
09/26/2012
Last updated
07/16/2014
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