| NPI | 1184848509 |
|---|---|
| Doing Business As | NONE |
| Entity Type | Organization |
| Authorized Contact | HOWLAND W. BICKERSTAFF Therapist 207-831-3328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC 1454) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME CC 1511) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |