| Full Name | Open Gate Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 221 North St, Saco, Maine |
| Authorized Official Name and Position | Jessica Wallner (OWNER) |
| Authorized Official Contact | 2077106505 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Open Gate Llc Po Box 12 Saco ME 04072-0012 Ph: () - | Open Gate Llc 221 North St Saco ME 04072-1843 Ph: (207) 590-4310 |
| NPI Number | 1164298360 |
|---|---|
| Provider Enumeration Date | 11/29/2023 |
| Last Update Date | 11/29/2023 |
| Certification Date | 11/29/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164298360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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