| Partnership For Trauma Recovery | |
|
45 Mallett Dr Freeport ME 04032-1312 | |
| (207) 894-8104 | |
| Not Available |
| Full Name | Partnership For Trauma Recovery |
|---|---|
| Speciality | Counselor |
| Location | 45 Mallett Dr, Freeport, Maine |
| Authorized Official Name and Position | Grace Wright (PARTNER) |
| Authorized Official Contact | 2078948104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Partnership For Trauma Recovery 491 Us Route 1 Ste 23 Freeport ME 04032-7022 Ph: (207) 318-8911 | Partnership For Trauma Recovery 45 Mallett Dr Freeport ME 04032-1312 Ph: (207) 894-8104 |
| NPI Number | 1518331032 |
|---|---|
| Provider Enumeration Date | 11/20/2015 |
| Last Update Date | 11/04/2024 |
| Certification Date | 11/04/2024 |
| Medicare PECOS PAC ID | 8426336850 |
|---|---|
| Medicare Enrollment ID | O20161104001777 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518331032 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
| Provider Name | Grace L Wright |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871844464 PECOS PAC ID: 8325361942 Enrollment ID: I20150106000856 |
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