| NPI | 1154954592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMSAM DAHIR Front Desk/ Hr 207-239-0634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2020-02-13 |
| Last Update Date | 2020-12-18 |