Healthcare Provider Details

I. General information

NPI: 1881522621
Provider Name (Legal Business Name): BRACE RECOVERY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 CHERRY HILL DR
WATERVILLE ME
04901-4503
US

IV. Provider business mailing address

11 CHERRY HILL DR
WATERVILLE ME
04901-4503
US

V. Phone/Fax

Practice location:
  • Phone: 240-224-3209
  • Fax: 240-224-3209
Mailing address:
  • Phone: 240-224-3209
  • Fax: 240-224-3209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: JESSE D DAMRON
Title or Position: OWNER
Credential: LADC, LSX, MHRT/C
Phone: 240-224-3209