| NPI | 1588426266 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN NIZEYE JENSON CEO 207-699-6134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 207QA0401X Family Medicine, Addiction Medicine | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2024-01-29 |
| Last Update Date | 2025-07-21 |