| NPI | 1023556776 |
|---|---|
| Other Name | GRACE STREET SOUTH |
| Entity Type | Organization |
| Authorized Contact | BRANDY BOYLE Billing Contact 207-245-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-02-02 |