| NPI | 1508547670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WENDY LYNNE FRAYER Clinical Social Worker 207-699-8046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2023-07-31 |
| Last Update Date | 2023-07-31 |