Healthcare Provider Details

I. General information

NPI: 1417543380
Provider Name (Legal Business Name): LIFELINE FOR ME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2020
Last Update Date: 06/01/2025
Certification Date: 06/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

76 MAIN ST
LIVERMORE FALLS ME
04254-1529
US

IV. Provider business mailing address

76 MAIN ST
LIVERMORE FALLS ME
04254-1529
US

V. Phone/Fax

Practice location:
  • Phone: 207-320-3305
  • Fax: 207-645-2372
Mailing address:
  • Phone: 207-320-3305
  • Fax: 207-645-2372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: AMANDA RICCI
Title or Position: OWNER/CEO
Credential: LADC, CCS, RN
Phone: 207-320-3299