| NPI | 1386035566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES WILLIAM GREEN Provider 207-941-1663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME LC5061) |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2015-02-10 |