| NPI | 1629218409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONNIE RAE CONDON Care Provider 207-435-6726 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2009-03-06 |
| Last Update Date | 2009-03-06 |