| NPI | 1376642066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTHA MARCHUT Clinical Manager 207-701-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ME 231141) |
| Additional Taxonomies | 251B00000X Case Management (Licence: ME 231141) |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: ME 231141) | |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2009-12-04 |