CASCO BAY RECOVERY NPI 1124797931

NPI Information

CASCO BAY RECOVERY is a substance abuse rehabilitation facility in Portland, ME. The provider is a facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. CASCO BAY RECOVERY NPI is 1124797931. The provider is registered as an organization entity type.

The provider's business location address is:

989 BRIGHTON AVE
PORTLAND, ME
ZIP 04102-022
Phone: (207) 332-2991
Fax: (772) 679-0244

The provider's authorized official is John Deberardinis .
The authorized official title is Director Of Ur and has the following contact phone number (781) 799-4350.

The CLIA number assigned to this NPI record is 20D2233274 - ancillary testing site in health care center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/7/2021 and was last updated on 9/7/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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