NPI | 1285438283 |
---|---|
Entity Type | Organization |
Authorized Contact | DOMINIQUE MAZAMBO CEO 207-409-2798 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2025-04-01 |
Last Update Date | 2025-04-01 |