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20D2158020 CLIA NUMBER - AWARE RECOVERY CARE OF MAINE

Laboratory Demographics

CLIA Number: 20D2158020

Facility Name: AWARE RECOVERY CARE OF MAINE

Facility Address:
500 SOUTHBOROUGH DR, STE 205
SOUTH PORTLAND, ME
ZIP 04106
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Facility Phone Number: 203 779-5799

Facility Type: Other - IN-HOME ADDICTION TRMTT

Certificate Type: Waiver
NPI Number: 1326444290

Taxonomy: 251E00000X - Home Health
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.

CLIA Record

Field Name Field Value
CLIA Number 20D2158020
LAB Type Other - IN-HOME ADDICTION TRMTT
Facility Name AWARE RECOVERY CARE OF MAINE
Street 500 SOUTHBOROUGH DR, STE 205
City SOUTH PORTLAND
State ME
ZIP 04106
Phone 203 779-5799
CertificateType 4
CertificateEffectiveDate 11/19/2022
CertificateExpirationDate 11/18/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024