| NPI | 1356496483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES MITCHELL Medical Director 207-874-1055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ME LC10806) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2020-08-22 |