| NPI | 1114159209 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN F. BURGESS Director 207-283-8574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ME CC1528) |
| Enumeration Date | 2009-08-22 |
| Last Update Date | 2009-08-22 |