| Grace Street Services Llc | |
|
105 Middle St Lewiston ME 04240-7037 | |
| (207) 212-9258 | |
| Not Available |
| Full Name | Grace Street Services Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 105 Middle St, Lewiston, Maine |
| Authorized Official Name and Position | Martin Joseph Obrien (DIRECTOR) |
| Authorized Official Contact | 2072129258 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Grace Street Services Llc 105 Middle St Lewiston ME 04240-7037 Ph: (207) 212-9258 | Grace Street Services Llc 105 Middle St Lewiston ME 04240-7037 Ph: (207) 212-9258 |
| NPI Number | 1639483233 |
|---|---|
| Provider Enumeration Date | 08/06/2010 |
| Last Update Date | 08/06/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639483233 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 605962 (Maine) | Primary |
| 251S00000X | Community/behavioral Health | 606205 (Maine) | Secondary |
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