Provider Demographics
NPI:1518331032
Name:PARTNERSHIP FOR TRAUMA RECOVERY
Entity Type:Organization
Organization Name:PARTNERSHIP FOR TRAUMA RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-894-8104
Mailing Address - Street 1:45 MALLETT DR
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04032-1312
Mailing Address - Country:US
Mailing Address - Phone:207-894-8104
Mailing Address - Fax:
Practice Address - Street 1:45 MALLETT DR
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:ME
Practice Address - Zip Code:04032-1312
Practice Address - Country:US
Practice Address - Phone:207-894-8104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty