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General NPI Number Information
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NPI Number | 1639046683
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Entity Type | Organization
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Legal Business Name | ALDA HEALTH LLC
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Dates
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Enumeration Date | 10/22/2025
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 225 GORHAM RD STE 104
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2462
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Country | US
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Telephone | 781-354-8051
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Fax |
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Provider Business Mailing Address
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Address Line | 8 LANES END
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City | IPSWICH
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State | MA
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Zip | 01938-2524
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO/CFO
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Name | JOHN AUER
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Credential |
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Telephone | 781-354-8051
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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