Provider Demographics
NPI:1134521206
Name:GRAC RECOVERY INC.
Entity type:Organization
Organization Name:GRAC RECOVERY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:OWEN
Authorized Official - Last Name:VURGASON
Authorized Official - Suffix:JR
Authorized Official - Credentials:MBA
Authorized Official - Phone:207-729-2828
Mailing Address - Street 1:87 GOVERNORS POINT RD
Mailing Address - Street 2:
Mailing Address - City:HARPSWELL
Mailing Address - State:ME
Mailing Address - Zip Code:04079-4339
Mailing Address - Country:US
Mailing Address - Phone:207-754-2601
Mailing Address - Fax:
Practice Address - Street 1:9 PARK ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530-2828
Practice Address - Country:US
Practice Address - Phone:207-754-2601
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-20
Last Update Date:2014-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health