Provider Demographics
NPI:1285455675
Name:TESSA LEE LIBBY TREATMENT CENTER
Entity type:Organization
Organization Name:TESSA LEE LIBBY TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BOARD MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROSAMOND
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:MCLEAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN, LADC
Authorized Official - Phone:207-266-0626
Mailing Address - Street 1:276 RAZORVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:ME
Mailing Address - Zip Code:04574-3817
Mailing Address - Country:US
Mailing Address - Phone:207-845-2232
Mailing Address - Fax:
Practice Address - Street 1:276 RAZORVILLE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:ME
Practice Address - Zip Code:04574-3817
Practice Address - Country:US
Practice Address - Phone:207-266-0626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-18
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility