| NPI | 1194376079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOAH DANIEL KRELL Owner 207-417-6260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-09-23 |
| Last Update Date | 2020-03-18 |