| NPI | 1164484093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY A TANGUAY Billing 207-767-0991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: ME 212936) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: ME 227222) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: ME 221141) | |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2015-04-15 |