| NPI | 1245474840 |
|---|---|
| Other Name | 1661 MAIN STREET |
| Entity Type | Organization |
| Authorized Contact | LISA BOLEN Accounting Manager 207-782-2726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2009-04-27 |
| Last Update Date | 2009-04-27 |