Organization
THE OPPORTUNITY ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA GENTILE (CHIEF FINANCIAL OFFICER)
(207) 874-1175
Entity
Organization
Contact information
Practice address
1329 BROADWAY, SOUTH PORTLAND, ME 04106-4110
(207) 874-1175
(207) 874-1181
Mailing address
50 MONUMENT SQ, PORTLAND, ME 04101-4039
(207) 874-1175
(207) 874-1181
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105460303
—
ME
Enumeration date
06/02/2009
Last updated
06/30/2020
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