Provider Demographics
NPI:1790093045
Name:RESPECTFUL LIVING, LLC
Entity Type:Organization
Organization Name:RESPECTFUL LIVING, LLC
Other - Org Name:JILL MERTINKE, LCPC
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:MERTINKE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:207-255-4833
Mailing Address - Street 1:107 DWELLEY RD
Mailing Address - Street 2:
Mailing Address - City:EAST MACHIAS
Mailing Address - State:ME
Mailing Address - Zip Code:04630-4003
Mailing Address - Country:US
Mailing Address - Phone:207-255-4833
Mailing Address - Fax:
Practice Address - Street 1:25 MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:MACHIAS
Practice Address - State:ME
Practice Address - Zip Code:04654-1165
Practice Address - Country:US
Practice Address - Phone:207-255-4833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-21
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC2367101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty