NPIMap

Organization Active NPI

Milestone Recovery

  • Substance Abuse Rehabilitation Facility
  • Portland, ME
National Provider Identifier
1063548436
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
License
238672 Issued in ME
Legal business name
MILESTONE RECOVERY
Practice address
65 India St
Portland, ME 04101-4209
Phone
(207) 775-4790
NPI assigned
Feb 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Thomas Doherty, MSW
Title
Executive Director
Phone
(207) 775-4790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X 238672 ME Primary

Addresses

Primary practice location

65 India St
Portland, ME 04101-4209

Mailing address

65 India St
Portland, ME 04101-4209
Phone (207) 775-4790

Other identifiers 2

IdentifierTypeStateIssuer
137990003MedicaidME
137990001MedicaidME

National Provider Directory

National Provider Directory
Tax ID family
Milestone Recovery3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

65 India St
Portland, ME 04101
Phone (207) 303-2481

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695168000000",
    "number": "1063548436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65 INDIA ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014209",
            "telephone_number": "207-775-4790",
            "fax_number": "207-775-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 INDIA ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014209",
            "telephone_number": "207-775-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILESTONE RECOVERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A",
        "authorized_official_last_name": "DOHERTY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "207-775-4790",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "ME",
            "license": "238672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137990003",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "137990001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.