Organization
A CENTER FOR LIFE ENHANCEMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANITA H. FLORES MA, CCC-SLP, LCPC (THERAPIST)
(207) 625-4525
Entity
Organization
Contact information
Practice address
100 MAPLE ST, CORNISH, ME 04020-3115
(207) 625-4525
Mailing address
100 MAPLE ST, CORNISH, ME 04020-3115
(207) 625-4525
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
CC953
ME
235Z00000X
Speech-Language Pathologist
SP277
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131370100
—
ME
05
—
131380099
—
ME
Enumeration date
05/21/2007
Last updated
05/20/2010
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