| NPI | 1487256186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN BURO Manager 207-910-6580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2024-06-03 |