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General NPI Number Information
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NPI Number | 1417422627
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Entity Type | Organization
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Legal Business Name | JEANNE SWEET PSYCHIATRIC SERVICES LLC
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Dates
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Enumeration Date | 10/04/2018
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Last Update Date | 12/13/2023
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Provider Practice Location Address
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Address Line | 22 RICHARDS ST
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-6530
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Country | US
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Telephone | 207-838-0898
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Fax |
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Provider Business Mailing Address
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Address Line | 22 RICHARDS ST
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-6530
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Country | US
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Telephone | 207-653-4561
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Fax | 207-560-9385
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Authorized Official
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Title or Position | SOLE OWNER
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Name | JEANNE C SWEET
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Credential |
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Telephone | 207-838-0898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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