Organization
SWEETSER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYNE VAN BRAMER (CEO)
(207) 294-4651
Entity
Organization
Contact information
Practice address
50 MOODY STREET, SACO, ME 04072
(800) 434-3000
(207) 294-4649
Mailing address
50 MOODY STREET, SACO, ME 04072
(800) 434-3000
(207) 294-4649
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
229941
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538122445
—
ME
Enumeration date
04/11/2006
Last updated
03/10/2023
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