Organization
GOODWILL INDUSTRIES OF NORTHERN NEW ENGLAND
Active
Other names
Goodwill of Maine
Organization subpart
No
Provider details
NPI number
Authorized official
SHARLENE ADAMS CBIST, LSX (SENIOR DIRECTOR, CLINICAL SVC)
(207) 795-6110
Entity
Organization
Contact information
Practice address
75 WASHINGTON AVENUE, SUITE 300, PORTLAND, ME 04101
(207) 774-6323
(207) 761-8460
Mailing address
75 WASHINGTON AVENUE, SUIT 300, PORTLAND, ME 04101
(207) 774-6323
(207) 761-8460
Taxonomy
Speciality
Code
Description
License number
State
103TP2701X
Group Psychotherapy Psychologist
—
—
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XN1300X
Neurorehabilitation Occupational Therapist
—
—
231H00000X
Audiologist
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104490000
—
ME
05
—
104490001
—
ME
05
—
104490002
—
ME
05
—
104490100
—
ME
05
—
104490200
—
ME
05
—
104490201
—
ME
05
—
104490300
—
ME
05
—
104490301
—
ME
05
—
104490302
—
ME
05
—
104490303
—
ME
Enumeration date
04/02/2007
Last updated
07/22/2014
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