Organization
SAGE PROGRAM, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARMAINE W KELLER LCSW,LICSW, CAP (OWNER)
(727) 481-3581
Entity
Organization
Contact information
Practice address
8 LUXURY DR, NEWPORT, NH 03773-1495
(727) 481-3581
Mailing address
8 LUXURY DR, NEWPORT, NH 03773-1495
(727) 481-3581
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/06/2015
Last updated
04/14/2021
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