Organization · NPI-2

Allagash Addiction Associates PLLC

Family Medicine, Addiction Medicine · Portland, ME

NPI number1699445361
StatusActive
Last updated in NPPESSep 15, 2021

Details

NPI
1699445361
Entity type
Organization (NPI-2)
Legal business name
Allagash Addiction Associates PLLC
Organization subpart
No
Enumeration date
Sep 15, 2021
Certification date
Sep 15, 2021
Last updated
Sep 15, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207QA0401X Family Medicine, Addiction Medicine––Yes
101YA0400X Counselor, Addiction (Substance Use Disorder)––

Practice location

254 Commercial St Ste 245
Portland, ME 04101-4899

Phone 207-558-6124

Mailing address

254 Commercial St Ste 245
Portland, ME 04101-4899

Phone 207-558-6124

Authorized official

Alane O'Connor
Owner
2075586124

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