| NPI | 1437370277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA MICHELLE PETERSON Clinical Supervisor 207-941-2824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: ME MC9998) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: ME MC9998) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |