Organization
BANGOR DETOX AND RECOVERY
Active
Organization
BANGOR DETOX AND RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN CERMELJ BBA (OWNER AND DIRECTOR)
(207) 408-7649
Entity
Organization
Contact information
Practice address
80 EXCHANGE ST STE 502, BANGOR, ME 04401-7914
(207) 408-7649
Mailing address
80 EXCHANGE ST STE 502, BANGOR, ME 04401-7914
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/05/2021
Last updated
03/07/2022
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