| NPI | 1467097709 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANASSE SHINGIRO Managing Member 207-415-6894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2019-11-11 |
| Last Update Date | 2019-11-11 |