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General NPI Number Information
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NPI Number | 1942328356
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Entity Type | Organization
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Legal Business Name | THE OPPORTUNITY ALLIANCE
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 09/10/2019
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Provider Practice Location Address
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Address Line | 190 LANCASTER ST
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City | PORTLAND
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State | ME
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Zip | 04101-2056
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Country | US
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Telephone | 207-874-1175
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Fax | 207-842-6886
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Provider Business Mailing Address
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Address Line | 50 LYDIA LN
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City | SOUTH PORTLAND
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State | ME
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Zip | 04106-2156
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Country | US
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Telephone | 207-874-1175
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Fax | 207-842-6886
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | DAWN OUELLETTE
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Credential |
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Telephone | 207-874-1175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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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 | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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