| NPI | 1245092766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FABIOLA JENSON Managing Director 207-409-4952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 251S00000X |
| 3104A0630X Assisted Living Facility, Assisted Living, Behavioral Disturbances | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2024-02-15 |