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General NPI Number Information
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NPI Number | 1326523366
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Entity Type | Organization
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Legal Business Name | AWARE RECOVERY CARE OF MAINE LLC
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Dates
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Enumeration Date | 09/26/2018
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 500 SOUTHBOROUGH DR STE 500-202
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-6928
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Country | US
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Telephone | 203-779-5799
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Fax |
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Provider Business Mailing Address
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Address Line | 35 THORPE AVE STE 104
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City | WALLINGFORD
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State | CT
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Zip | 06492-1948
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Country | US
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Telephone | 203-779-5799
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Fax | 203-421-6830
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Authorized Official
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Title or Position | CFO
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Name | GEORGE MERHI
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Credential |
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Telephone | 203-779-5799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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