TRADECRAFT12 INC. NPI 1740688472

NPI Information

NPI: 1740688472
Provider Name: TRADECRAFT12 INC.
Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

CLIA Number: 20D2094100

Address:
160 PREBLE ST
PORTLAND, ME
ZIP 04101
Phone: (207) 420-7327
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TRADECRAFT12 INC. is a rehabilitation and substance use disorder clinic center in Portland, ME. TRADECRAFT12 INC. NPI is 1740688472. The provider is registered as an organization entity type.

The provider's business location address is:

160 PREBLE ST
PORTLAND, ME
ZIP 04101-426
Phone: (207) 420-7327

The provider's authorized official is Danika Babcock .
The authorized official title is President and has the following contact phone number (207) 329-2444.

The CLIA number assigned to this NPI record is 20D2094100 - other - behavioral health facilit with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/11/2014 and was last updated on 6/8/2017.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder		MAINE	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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