| NPI | 1053555656 |
|---|---|
| Other Name | MMCC 1501 |
| Entity Type | Organization |
| Authorized Contact | LISA BOLEN Accounting Manager 207-782-2726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |