| Portland Opioid Health Home | |
|
48 Free St. Mezzanine Level Portland ME 04101 | |
| (207) 808-1384 | |
| (207) 221-1710 |
| Full Name | Portland Opioid Health Home |
|---|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
| Location | 48 Free St., Portland, Maine |
| Authorized Official Name and Position | Constance W Jordan (CEO) |
| Authorized Official Contact | 2078081384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Opioid Health Home 48 Free St. Mezzanine Level Portland ME 04101 Ph: (207) 808-1384 | Portland Opioid Health Home 48 Free St. Mezzanine Level Portland ME 04101 Ph: (207) 808-1384 |
| NPI Number | 1841855301 |
|---|---|
| Provider Enumeration Date | 05/09/2019 |
| Last Update Date | 05/09/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841855301 | NPI | - | NPPES |
| 193200000X | Medicaid | ME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Primary |
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