| NPI | 1093461188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRAVIS JEROME LENFEST Therapist 207-631-8968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-02-27 |
| Last Update Date | 2022-03-31 |