Organization
INTERBLOOM THERAPY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAQUEL ROSSI LCSW (THERAPIST)
(516) 710-6308
Entity
Organization
Contact information
Practice address
95 INDIA ST STE 3, PORTLAND, ME 04101-4250
(516) 710-6308
Mailing address
56 CROSS HILL RD, CAPE ELIZABETH, ME 04107-5116
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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