Portland Recovery Collective, LLC

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

Legal business name

PORTLAND RECOVERY COLLECTIVE, LLC

Practice address

509 Forest Ave
Portland, ME 04101-1521

Phone

(617) 690-9020

NPI assigned

Nov 22, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lisa Nashawaty

Title

Ceo

Phone

(617) 690-9020

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1013674217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 REDLON RD",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022218",
            "telephone_number": "617-690-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 FOREST AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041011521",
            "telephone_number": "617-690-9020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND RECOVERY COLLECTIVE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "NASHAWATY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "617-690-9020"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Portland Psychiatric Services, LLC
• Portland Public Schools
• Portland Public Schools
• Portland Public Schools
• Portland Public Schools
• Portland Recovery Group LLC
• Portland Smiles PA
• Portland Surgical Associates
• Portland West Inc.
• Dawson Postl

• Substance Use Disorder Rehabilitation Clinic/Center in Portland, ME
• Providers in Portland, ME by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.