| NPI | 1245547280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA G COWAN Administrator 207-794-2150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ME 266141) |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2011-04-04 |