| NPI | 1427746189 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SALLIE ALICIA MCCOURT ALBERT Owner 207-523-9158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2023-04-28 |
| Last Update Date | 2023-04-28 |