| NPI | 1003597055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARON REYNOLDS Exec Admin Director 207-505-0143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |