| NPI | 1164858460 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISE L MAGNUSON Psychologist 207-782-2726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: ME 346501) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2013-09-18 |