Organization
BAYSIDE NEUROREHABILITATION SERVICES
Active
Other names
Good Will Industries of New England
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANN P COSTELLO LCSW (CLINICAL SOCIAL WORKER)
(207) 761-8402
Entity
Organization
Contact information
Practice address
26 PORTLAND ST, PORTLAND, ME 04101-2912
(207) 261-8402
(207) 271-8405
Mailing address
26 PORTLAND ST, PORTLAND, ME 04101-2912
(207) 261-8402
(207) 271-8405
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
LC9494
ME
Other
Enumeration date
05/20/2008
Last updated
05/20/2008
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