Organization Active NPI

The Opportunity Alliance

  • Mental Illness Community Based Residential Treatment Facility
  • South Portland, ME
National Provider Identifier
1154557452
Registry record updated Jun 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
THE OPPORTUNITY ALLIANCE
Practice address
1329 Broadway
South Portland, ME 04106-4110
Phone
(207) 874-1175
Fax
(207) 874-1181
NPI assigned
Jun 2, 2009
Last updated
Jun 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2020

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

Authorized official

Name
Virginia Gentile
Title
Chief Financial Officer
Phone
(207) 874-1175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X Primary

Addresses

Primary practice location

1329 Broadway
South Portland, ME 04106-4110

Mailing address

50 Monument SQ
Portland, ME 04101-4039
Phone (207) 874-1175

Other identifiers 1

IdentifierTypeStateIssuer
105460303MedicaidME

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
20D2202715Broadway Crossings the Opportunity Alliance1329 Broadway, South Portland, ME 04106Certificate of waiverNov 30, 2026

National Provider Directory

National Provider Directory
Tax ID family
The Opportunity Alliance6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1154557452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MONUMENT SQ",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041014039",
            "telephone_number": "207-874-1175",
            "fax_number": "207-874-1181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 BROADWAY",
            "city": "SOUTH PORTLAND",
            "state": "ME",
            "postal_code": "041064110",
            "telephone_number": "207-874-1175",
            "fax_number": "207-874-1181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OPPORTUNITY ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "GENTILE",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "207-874-1175"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105460303",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.