Organization
TRADECRAFT12 INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIKA BABCOCK (PRESIDENT)
(207) 329-2444
Entity
Organization
Contact information
Practice address
160 PREBLE ST, PORTLAND, ME 04101-2426
(207) 420-7327
Mailing address
38 DEERING STREET, PORTLAND, ME 04101
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
ME
Other
Enumeration date
12/11/2014
Last updated
06/08/2017
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