GRACE STREET SERVICES, LLC (NPI# 1417494857) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417494857 |
| Entity Type | Organization |
| Organization Name | GRACE STREET SERVICES, LLC |
| Other Organization Name | GRACE STREET SERVICES PORTLAND |
| Practice Address |
72 Auburn St Portland ME 04103-2104 |
| Mailing Address |
550 Lisbon St Lewiston ME 04240-6580 |
| Practice Telephone | 2072451800 |
| Enumeration Date | 2017-01-24 |
| Last Update Date | 2017-01-24 |
| Authorized Official Name | BRANDY BOYLE (BILLING CONTACT) |
| Authorized Official Telephone | 2072451800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities |
| Other Name | Type Code |
|---|---|
| Grace Street Services Portland | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023556776 | Grace Street Services, LLC | Substance Abuse Rehabilitation Facility | 69 Eagle Drive, Sanford, ME 04073 | 2017-02-02 |
| 1568900074 | Grace Street Services, LLC | Substance Abuse Rehabilitation Facility | 88 Oxford St, Lewiston, ME 04240-7825 | 2017-02-03 |
| Street Address |
72 AUBURN ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-2104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598208191 | Heather Lynn Maloney | Counselor | 72 Auburn St, Portland, ME 04103-2104 | 2016-11-30 |
| 1841722378 | Jason William Nickerson | Counselor | 72 Auburn St, Portland, ME 04103-2104 | 2017-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 324500000X |
| Grouping | Residential Treatment Facilities |
| Classification | Substance Abuse Rehabilitation Facility |
| A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances. |
| Notes: [7/1/2003: modified title, modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477002228 | Treehouse Nw Inc | Substance Abuse Rehabilitation Facility | 4713 N Albina Ave, Suite 301, Portland, OR 97217-2605 | 2016-09-21 |
| 1154785475 | Blvd Centers, Inc | Substance Abuse Rehabilitation Facility | 1316 Se 12th Ave, Portland, OR 97214-3604 | 2016-04-12 |
| 1104219211 | Allied Health Services | Substance Abuse Rehabilitation Facility | 808 Se Alder St, Portland, OR 97214-2213 | 2015-03-13 |
| 1700297074 | Pathfinders of Oregon | Substance Abuse Rehabilitation Facility | 7800 Sw Barbur Blvd, Portland, OR 97219-2823 | 2014-05-08 |
| 1194037283 | De Paul Treatment Centers | Substance Abuse Rehabilitation Facility | 1312 Sw Washington St., Portland, OR 97208 | 2010-07-06 |
| 1649412511 | Portland Detox | Substance Abuse Rehabilitation Facility | 11160 Sw Waverly Pl, Portland, OR 97225-4456 | 2009-03-24 |
| 1144432907 | Serenity House, Inc. | Substance Abuse Rehabilitation Facility | 30 Mellen St, Portland, ME 04101-2110 | 2007-05-04 |
| 1063548436 | Milestone Foundation Inc | Substance Abuse Rehabilitation Facility | 65 India St, Portland, ME 04101-4209 | 2007-02-27 |
| 1851428775 | Depaul Treatment Centers Inc. | Substance Abuse Rehabilitation Facility | 5052 Ne 42nd Ave, Portland, OR 97218-1550 | 2007-02-27 |
| 1114546645 | Nw Insituto Latino | Substance Abuse Rehabilitation Facility | 2054 N Vancouver Ave, Portland, OR 97227-1917 | 2020-04-14 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.