Healthcare Provider Details

I. General information

NPI: 1982170254
Provider Name (Legal Business Name): THE COURAGEOUS STEPS PROJECT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2018
Last Update Date: 05/24/2022
Certification Date: 05/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

78 MAIN ROAD
MILFORD ME
04461-0729
US

IV. Provider business mailing address

P.O. BOX 729
MILFORD ME
04461-0729
US

V. Phone/Fax

Practice location:
  • Phone: 207-827-7270
  • Fax: 207-827-2812
Mailing address:
  • Phone: 207-827-7270
  • Fax: 207-827-2812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. CONNOR JACOB ARCHER
Title or Position: CHAIRMAN/CEO
Credential: MBA
Phone: 207-852-1831