| Portland Recovery Group Llc | |
|
1584 Forest Ave Portland ME 04103-1314 | |
| (207) 838-4546 | |
| Not Available |
| Full Name | Portland Recovery Group Llc |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 1584 Forest Ave, Portland, Maine |
| Authorized Official Name and Position | Alexander Philip Coupe (OWNER) |
| Authorized Official Contact | 2078384546 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Recovery Group Llc 27 Cypress St Portland ME 04103-2008 Ph: (207) 838-4546 | Portland Recovery Group Llc 1584 Forest Ave Portland ME 04103-1314 Ph: (207) 838-4546 |
| NPI Number | 1093492969 |
|---|---|
| Provider Enumeration Date | 06/30/2023 |
| Last Update Date | 06/30/2023 |
| Certification Date | 06/30/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093492969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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