TRADECRAFT12 INC. (NPI# 1740688472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740688472 |
| Entity Type | Organization |
| Organization Name | TRADECRAFT12 INC. |
| Practice Address |
160 Preble St Portland ME 04101-2426 |
| Mailing Address |
38 Deering Street Portland ME 04101 |
| Practice Telephone | 2074207327 |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2017-06-08 |
| Authorized Official Name | DANIKA BABCOCK (PRESIDENT) |
| Authorized Official Telephone | 2073292444 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
ME | Ambulatory Health Care Facilities |
| Street Address |
160 PREBLE ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04101-2426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093149106 | Nicole Firth | Social Worker | 160 Preble St, Portland, ME 04101-2426 | 2013-08-26 |
| 1275140923 | Danielle Shaw Cimino | Counselor | 160 Preble St, Portland, ME 04101-2426 | 2020-09-28 |
| 1659990752 | Sara Santina Larkin | Counselor | 160 Preble St, Portland, ME 04101-2426 | 2020-04-09 |
| 1174163026 | Jennifer Formicola | Counselor | 160 Preble St, Portland, ME 04101-2426 | 2020-01-08 |
| 1215339809 | Pk Holdings, Inc. | Substance Abuse Rehabilitation Facility | 160 Preble St, Portland, ME 04101-2426 | 2014-09-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306450655 | Jocylin Egan | Nurse Practitioner | 442 Congress Street, 2nd Floor, Portland, ME 04101 | 2020-09-03 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1578101929 | Mohamed Hassan Mohamed | Student in an Organized Health Care Education/Training Program | 75 Lancaster St Ste 218a, Portland, ME 04101 | 2019-12-17 |
| 1841855301 | Portland Opioid Health Home | Counselor | 48 Free St., Mezzanine Level, Portland, ME 04101 | 2019-05-09 |
| 1093379224 | Alexandra Strawbridge Maurer | Acupuncturist | 50 A Cove Street, Portland, ME 04101 | 2019-04-23 |
| 1245719541 | Scott J Whited | Nurse Practitioner | 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 | 2018-08-08 |
| 1144733064 | Alixandria Elaine Marie Winchell | Massage Therapist | One City Center, Portland, ME 04101 | 2017-11-14 |
| 1417473638 | Rachel S Schwaner | Occupational Therapist | 78 Danforth Street, Apartment 6, Portland, ME 04101 | 2017-08-18 |
| 1023538154 | Derina Boothroyd | Audiologist-Hearing Aid Fitter | 985 Forest Ave., Portland, ME 04101 | 2017-06-20 |
| 1881123297 | Mark Mccullough | Social Worker | 57 Exchange Street, Suite 403, Portland, ME 04101 | 2017-06-08 |
| Find all providers in zip 04101 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952940298 | New Start Program | Clinic/Center | 12180 Se Market St, Portland, OR 97216-3923 | 2020-01-03 |
| 1992204697 | Sober Living Oregon Treatment Center | Clinic/Center | 10209 Se Division, Portland, OR 97266 | 2018-02-08 |
| 1447605258 | Crestview Recovery Services, LLC | Clinic/Center | 6027 Se Belmont St, Portland, OR 97215-1927 | 2016-04-29 |
| 1669856571 | Portland Iop, LLC | Clinic/Center | 748 Se 181st Ave, Portland, OR 97233-4945 | 2015-07-10 |
| 1801947668 | Crc Health Oregon, LLC | Clinic/Center | 324 Nw Davis St., Portland, OR 97209 | 2007-01-16 |
| 1558412320 | Crc Health Oregon, LLC | Clinic/Center | 2600 Se Belmont St, Portland, OR 97214 | 2007-01-16 |
| 1932250719 | Crc Health Oregon, LLC | Clinic/Center | 6601 Ne 78th Court, Ste A3, Portland, OR 97218 | 2007-01-16 |
| 1326056433 | Lutheran Community Services Northwest | Clinic/Center | 605 Se Cesar E Chavez Blvd, Portland, OR 97214-3216 | 2006-08-04 |
| 1952360760 | Transitions Counseling, Inc. | Clinic/Center | 583 Forest Ave, Portland, ME 04101-1547 | 2006-03-21 |
| 1194297671 | Silver Lining Treatment Center (dba) Recovery Blvd | Clinic/Center | 10209 Se Division St Bldg D, Portland, OR 97266-1372 | 2018-12-21 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on TRADECRAFT12 INC..
| 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.