| NPI | 1215773908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIC SURU CEO 207-409-4577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-07-02 |
| Last Update Date | 2024-10-27 |