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Organization

WEST END PRACTICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CLAUDINE GRANGE PMH-NP (OWNER, PSYCHIATRIC NP)
(207) 272-5106
Entity
Organization

Contact information

Practice address
95 PINE ST, PORTLAND, ME 04102-3719
(207) 272-5106
(207) 839-4704
Mailing address
95 PINE ST, PORTLAND, ME 04102-3719
(207) 272-5106
(207) 839-4704

Taxonomy

Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
AP081848
ME

Other

Enumeration date
12/23/2009
Last updated
12/23/2009
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