| NPI | 1558465575 |
|---|---|
| Other Name | ELM STREET RESIDENCE |
| Entity Type | Organization |
| Authorized Contact | RICHARD M WEISS Executive Director 207-626-3465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: ME 231968) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2020-08-22 |