| NPI | 1558634246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY MAIELLO Owner 207-752-0731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X (Licence: NH 653) |
| Enumeration Date | 2012-02-12 |
| Last Update Date | 2021-10-04 |