Bayside Neurorehabilitation Services

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

LC9494 Issued in ME

Legal business name

BAYSIDE NEUROREHABILITATION SERVICES

Doing business as

Good Will Industries of New England

Practice address

26 Portland St
Portland, ME 04101-2912

Phone

(207) 261-8402

Fax

(207) 271-8405

NPI assigned

May 20, 2008

Last updated

May 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Ann P Costello, LCSW

Title

Clinical Social Worker

Phone

(207) 761-8402

Specialties & licenses 1

Addresses

Other names 1

• Good Will Industries of New England Doing business as

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

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1881851517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 PORTLAND ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012912",
            "telephone_number": "207-261-8402",
            "fax_number": "207-271-8405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 PORTLAND ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041012912",
            "telephone_number": "207-261-8402",
            "fax_number": "207-271-8405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE NEUROREHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-20",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "207-761-8402",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "ME",
            "license": "LC9494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Will Industries of New England",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Emily Paige Baxter, MD
• Bay Wellness Family Chiropractic LLC.
• Christian Bayingana, MD
• Bayside Care LLC
• Bayside Employee Health Center
• Bayside Psychology and Consulting, LLC
• Allison L. Baysol, PA-C
• Bayview Care Agency LLC
• Richard A Bazarian, MD
• Alexandra Bazinet, RDH

• Medical Specialty Clinic/Center in Portland, ME
• Providers in Portland, ME by specialty
• Medical Specialty Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.