Organization
THE CHARLIE MIKE PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARLOS L LOPEZ (PRESIDENT)
(207) 403-9215
Entity
Organization
Contact information
Practice address
213 W BROADWAY, LINCOLN, ME 04457-4001
(207) 403-9215
Mailing address
PO BOX 307, LINCOLN, ME 04457-0307
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
02/03/2020
Last updated
02/03/2020
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