Organization
GRACE STREET SERVICES, LLC
Active
Other names
Grace Street Services Portland
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDY BOYLE (BILLING CONTACT)
(207) 245-1800
Entity
Organization
Contact information
Practice address
72 AUBURN ST, PORTLAND, ME 04103-2104
(207) 245-1800
Mailing address
550 LISBON ST, LEWISTON, ME 04240-6580
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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