| NPI | 1174788236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGEL D.C. FULLER-MCMAHAN President/Owner 207-594-8433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ME 478019) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: ME 604311) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2010-06-23 |