| NPI | 1538911904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYSHA WOODYE Registered Nurse 207-400-5188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |