| NPI | 1063431070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY L BERGNER Accounts Receivable Coordinator 207-782-2726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant |
| 225XM0800X Occupational Therapist, Mental Health | |
| 235Z00000X Speech-Language Pathologist, | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X | |
| 252Y00000X Early Intervention Provider Agency | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2021-06-24 |