Chellis, Jack

Chellis, Jack is an individual health care provider with primary practice located at 28 Portland Ave , Old Orchard Beach ME 04064-2212. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Chellis, Jack can be contacted via phone (207) 934-5231.

Contact Information

Primary practice address
28 Portland Ave Old Orchard Beach ME 04064-2212
Phone: (207) 934-5231
Fax: (207) 934-5139
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X CAC5765 Maine

Profile Details

NPI number 1114317179
LBN Legal business name Chellis, Jack
Credentials CADC
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2015
Last updated Jan 29th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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