OrganizationActive
Liberty Bay Recovery Center, LLC
NPI 1104212182 · Substance Use Disorder Rehabilitation Clinic/Center · Portland, ME
Provider details
- NPI number
- 1104212182
- Entity type
- Organization
- Primary specialty
- Substance Use Disorder Rehabilitation Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Bruce Jarvie, Vp, Treasurer(214) 379-3300
Specialties & taxonomies
Ambulatory Health Care Facilities
- Substance Abuse Rehabilitation Facility324500000X
Residential Treatment Facilities
Practice location
343 Forest Ave
Portland, ME 04101-2006
Phone: (207) 772-9800
Fax: (207) 536-1511
Approximate (ZIP-level) locationGet directions
Mailing address
343 Forest Ave
Portland, ME 04101-2006
Registry dates
- Enumerated
- 2015-04-07
- Last updated
- 2024-09-04
- Certified
- 2024-09-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.