| NPI | 1013244797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY FAULKNER Administrator 207-425-3880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2009-11-17 |