| NPI | 1043642762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH THIBODEAU Revenue Manager 207-878-9663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: ME RN34651) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-08-05 |
| Last Update Date | 2024-11-25 |