The Charlie Mike Project

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Legal business name

THE CHARLIE MIKE PROJECT

Practice address

213 W Broadway
Lincoln, ME 04457-4001

Phone

(207) 403-9215

NPI assigned

Feb 3, 2020

Last updated

Feb 3, 2020By 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

Mr. Carlos L Lopez

Title

President

Phone

(207) 403-9215

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1912538430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 307",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044570307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 W BROADWAY",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044574001",
            "telephone_number": "207-403-9215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CHARLIE MIKE PROJECT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "CARLOS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "207-403-9215",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Lynn Stanley
• Kayla Jayne Stevens, MS OTR/L
• Garrett Stiles, PHARMD
• Gordon Powell Street, PHD
• Beatrice Mary Szantyr, M.D.
• The Riverside Community Center, Inc
• Heidi Theriault, RN
• Harrold Joseph Thibodeau Jr., DMD
• Garnette Thompson
• Togus Vamc

• Substance Abuse Rehabilitation Facility in Lincoln, ME
• Providers in Lincoln, ME by specialty
• Substance Abuse Rehabilitation Facility in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.