Organization
PORTLAND RECOVERY COLLECTIVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LISA NASHAWATY (CEO)
(617) 690-9020
Entity
Organization
Contact information
Practice address
509 FOREST AVE, PORTLAND, ME 04101-1521
(617) 690-9020
Mailing address
22 REDLON RD, PORTLAND, ME 04102-2218
(617) 690-9020
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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