LIBERTY BAY RECOVERY CENTER, LLC
NPI 1104212182
Clinic/Center - Rehabilitation, Substance Use Disorder in Portland, ME

Q: What is Liberty Bay Recovery Center, LLC's NPI number?

The NPI number for Liberty Bay Recovery Center, LLC is 1104212182. It was assigned to this organization in the NPPES registry on April 7, 2015.

Q: What is Liberty Bay Recovery Center, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Active since April 07, 2015CLIA 20D2111660 · Waiver

343 FOREST AVE, PORTLAND, ME 04101(207) 772-9800(207) 536-1511 Get Directions Write a Review

NPPES record last updated: September 4, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Sep 4, 2024, Jul 29, 2024, Feb 21, 2023 and 2 more (5 updates tracked since 2018).

On this page

About Liberty Bay Recovery Center, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIBERTY BAY RECOVERY CENTER, LLC (NPI 1104212182) is a healthcare organization registered as a rehabilitation, substance use disorder in Portland, Maine and active in the NPI registry since April 2015. The organization holds a CLIA Waiver certificate valid through April 11, 2028 and lists Bruce Jarvie, Vp, Treasurer, as its authorized official.

NPPES Registry Identity

NPI1104212182

Entity TypeOrganization

Primary Taxonomy261QR0405X

Legal Business NameLIBERTY BAY RECOVERY CENTER, LLC

Location Address343 FOREST AVEPortland, ME 04101-2006

Mailing Address343 Forest AvePortland, ME 04101-2006 · (207) 772-9800 · Fax (207) 536-1511

Phone(207) 772-9800

Fax(207) 536-1511

Organization SubpartNo

Authorized OfficialBruce JarvieVp, Treasurer · (214) 379-3300

Enumeration DateApril 7, 2015

Last NPPES UpdateSeptember 4, 20245 updates tracked since enumeration

NPPES CertifiedSeptember 4, 2024

✔ NPI 1104212182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities

Taxonomy Code261QR0405X

License✔ Licensed in ME · 684958

Also ListedSubstance Abuse Rehabilitation FacilityTaxonomy 324500000X

343 FOREST AVE, Portland, ME 04101

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D2111660

Liberty Bay Recovery Center, LLC · Portland, ME

Active · expires Apr 11, 2028

CLIA Number20D2111660

Laboratory TypeNarcotic Treat Center

Certificate Effective DateApril 12, 2026

Certificate Expiration DateApril 11, 2028

Laboratory DirectorMichael A. Bell

Laboratory Phone(855) 607-8758

Laboratory LocationLiberty Bay Recovery Center, LLC343 Forest Avenue, Portland, ME 04101

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT ROCKETT LCSW

Social Worker (Clinical)