| NPI | 1154595684 |
|---|---|
| Former Legal Business Name | PORTLAND WEST |
| Entity Type | Organization |
| Authorized Contact | ROBERT E. DODGE Chief Financial Officer 207-775-0105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ME 566270) |
| Additional Taxonomies | 174400000X Specialist (Licence: ME 566270) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2012-10-02 |