Kaleidoscope Eating Disorders and Diet Recovery Center
Clinic/Center (Health Service)

Address: 75 Market St Ste 304, Portland, ME 04101-5040
Phone: 2072055505

Kaleidoscope Eating Disorders and Diet Recovery Center (NPI# 1356960728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1356960728
Entity Type Organization
Practice Address 75 Market St Ste 304
ME 04101-5040
Practice Telephone 2072055505
Mailing Address 75 Market St Ste 304
ME 04101-5040
Mailing Telephone 2072055505
Authorized Official Name Amy Grimm (CO-OWNER)
Authorized Official Telephone 2072055505
Authorized Official Credential RDN
Organization Subpart No, this organization is not a Subpart
Enumeration Date 2020-04-15
Last Update Date 2020-04-15

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 261QH0100X Clinic/Center · Health Service Ambulatory Health Care Facilities

Taxonomy Information

Taxonomy Code 261QH0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Health Service

Taxonomy Definition

Definition to come...
Notes: [7/1/2006: modified title]

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Office Location

Street Address 75 MARKET ST STE 304
State ME
Zip Code 04101-5040

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073127312 Alissa Sullivan Social Worker 75 Market St Ste 304, Portland, ME 04101-5040 2020-09-03

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1851996987 Karen Tinkham Pharmacist 2r 295 Forest Ave., Portland, ME 04101 2020-12-04
1669076121 Dawn Lisowski Pharmacist 2r 295 Forest Ave, Hannaford Plaza, Portland, ME 04101 2020-11-25
1306450655 Jocylin Egan Nurse Practitioner 442 Congress Street, 2nd Floor, Portland, ME 04101 2020-09-03
1255963559 Portcity Home Healthcare LLC In Home Supportive Care 525 Forest Avenue, Suite 8, Portland, ME 04101 2020-02-05
1578101929 Mohamed Hassan Mohamed Student in an Organized Health Care Education/Training Program 75 Lancaster St Ste 218a, Portland, ME 04101 2019-12-17
1841855301 Portland Opioid Health Home Counselor 48 Free St., Mezzanine Level, Portland, ME 04101 2019-05-09
1093379224 Alexandra Strawbridge Maurer Acupuncturist 50 A Cove Street, Portland, ME 04101 2019-04-23
1245719541 Scott J Whited Nurse Practitioner 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 2018-08-08
1144733064 Alixandria Elaine Marie Winchell Massage Therapist One City Center, Portland, ME 04101 2017-11-14
1417473638 Rachel S Schwaner Occupational Therapist 78 Danforth Street, Apartment 6, Portland, ME 04101 2017-08-18
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Zip Code 04101

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.