NPIMap

Organization Active NPI

Portland Opioid Health Home

  • Addiction (Substance Use Disorder) Counselor
  • Portland, ME
National Provider Identifier
1841855301
Registry record updated May 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Legal business name
PORTLAND OPIOID HEALTH HOME
Practice address
48 Free St.
Mezzanine Level
Portland, ME 04101
Phone
(207) 808-1384
Fax
(207) 221-1710
NPI assigned
May 9, 2019
Last updated
May 9, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2019

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

Authorized official

Name
Constance W Jordan, NPNPI 1518939032
Title
Ceo
Phone
(207) 808-1384

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

48 Free St.
Mezzanine Level
Portland, ME 04101

Mailing address

48 Free St.
Mezzanine Level
Portland, ME 04101
Phone (207) 808-1384

Other identifiers 1

IdentifierTypeStateIssuer
193200000XMedicaidME

National Provider Directory

National Provider Directory

Locations

48 Free St
Portland, ME 04101
Phone (207) 808-1384

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557360000000",
    "number": "1841855301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 FREE ST.",
            "address_2": "MEZZANINE LEVEL",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04101",
            "telephone_number": "207-808-1384",
            "fax_number": "207-221-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48 FREE ST.",
            "address_2": "MEZZANINE LEVEL",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "04101",
            "telephone_number": "207-808-1384",
            "fax_number": "207-221-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND OPIOID HEALTH HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "CONSTANCE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-808-1384",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193200000X",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.