Organization
THE OPPORTUNITY ALLIANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN HAWLEY (REVENUE MANAGER)
(207) 523-5018
Entity
Organization
Contact information
Practice address
50 LYDIA LN, SOUTH PORTLAND, ME 04106-2156
(207) 874-1175
(207) 874-1181
Mailing address
50 LYDIA LN, SOUTH PORTLAND, ME 04106-2156
(207) 874-1175
(207) 874-1181
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105460200
—
ME
05
—
105460201
—
ME
05
—
105460202
—
ME
05
—
105460203
—
ME
05
—
105460204
—
ME
05
—
105460205
—
ME
05
—
105460206
—
ME
05
—
105460212
—
ME
05
—
105460215
—
ME
05
—
105460217
—
ME
05
—
105460218
—
ME
05
—
105460225
—
ME
05
—
105460226
—
ME
05
—
105460227
—
ME
05
—
105460228
—
ME
05
—
105460229
—
ME
05
—
105460230
—
ME
05
—
105460231
—
ME
05
—
105460233
—
ME
Enumeration date
06/02/2009
Last updated
10/09/2018
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