| NPI | 1114153939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLEY GORDON Executive Director 207-623-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: ME 3095) |
| Enumeration Date | 2009-06-08 |
| Last Update Date | 2019-11-20 |