Organization
THE INTEGRATED LIFE
Active
Other names
Jamie Racine
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE RACINE LCSW (FOUNDER/CLINICAL DIRECTOR)
(207) 894-4278
Entity
Organization
Contact information
Practice address
28 STATE ST STE 5, GORHAM, ME 04038-1147
(207) 894-4278
Mailing address
28 STATE ST STE 5, GORHAM, ME 04038-1147
(207) 894-4278
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508103052
NPI
ME
05
—
METPID007108
—
ME
Enumeration date
04/12/2022
Last updated
04/12/2022
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