| Allagash Addiction Associates Pllc | |
|
254 Commercial St Ste 245 Portland ME 04101-4899 | |
| (207) 558-6124 | |
| Not Available |
| Full Name | Allagash Addiction Associates Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 254 Commercial St Ste 245, Portland, Maine |
| Authorized Official Name and Position | Alane O'connor (OWNER) |
| Authorized Official Contact | 2075586124 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allagash Addiction Associates Pllc 254 Commercial St Ste 245 Portland ME 04101-4899 Ph: (207) 558-6124 | Allagash Addiction Associates Pllc 254 Commercial St Ste 245 Portland ME 04101-4899 Ph: (207) 558-6124 |
| NPI Number | 1699445361 |
|---|---|
| Provider Enumeration Date | 09/15/2021 |
| Last Update Date | 09/15/2021 |
| Certification Date | 09/15/2021 |
| Medicare PECOS PAC ID | 3072910330 |
|---|---|
| Medicare Enrollment ID | O20210929001509 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699445361 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | (* (Not Available)) | Primary |
| Provider Name | Alane O Connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679540546 PECOS PAC ID: 4688682842 Enrollment ID: I20060329000523 |
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