NPIMap

Organization Active NPI

Grace Street Services, LLC

  • Substance Abuse Rehabilitation Facility
  • Sanford, ME
National Provider Identifier
1023556776
Registry record updated Feb 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X
Legal business name
GRACE STREET SERVICES, LLC
Practice address
69 Eagle Drive
Sanford, ME 04073
Phone
(207) 245-1800
NPI assigned
Feb 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2017

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

Authorized official

Name
Brandy Boyle
Title
Billing Contact
Phone
(207) 245-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Abuse Rehabilitation Facility 324500000X Primary

Addresses

Primary practice location

69 Eagle Drive
Sanford, ME 04073

Mailing address

550 Lisbon St
Lewiston, ME 04240-6580

Other names 1

  • Grace Street South Other name

National Provider Directory

National Provider Directory
Tax ID family
Grace Street Services LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

550 Lisbon St
Lewiston, ME 04240
Phone (207) 514-0829

NPI Registry JSON

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485993600000",
    "number": "1023556776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 LISBON ST",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 EAGLE DRIVE",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "04073",
            "telephone_number": "207-245-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRACE STREET SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-02",
        "last_updated": "2017-02-02",
        "status": "A",
        "authorized_official_last_name": "BOYLE",
        "authorized_official_first_name": "BRANDY",
        "authorized_official_title_or_position": "BILLING CONTACT",
        "authorized_official_telephone_number": "207-245-1800"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grace Street South",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Sanford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2017; 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.