National Provider Identifier Database

PORTLAND RECOVERY COLLECTIVE LLC
Rehabilitation, Substance Use Disorder


Contact Information

PORTLAND RECOVERY COLLECTIVE, LLC
509 FOREST AVE
PORTLAND, ME04101-1521
Phone: 617-690-9020
Fax:
Website:
Specialty Taxonomy Code
* Rehabilitation, Substance Use Disorder 261QR0405X

* Indicates primary specialty

NPI Profile & details for PORTLAND RECOVERY COLLECTIVE, LLC

NPI Number 1013674217
Legal business name
LBN
PORTLAND RECOVERY COLLECTIVE, LLC
Authorized official LISA NASHAWATY - (CEO)
Entity Organization
Organization subpart No
Enumeration date 11/22/2021
Last updated 11/22/2021 - About 5 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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