NPI | 1639860570 |
---|---|
Entity Type | Organization |
Authorized Contact | DORIANE GUSA KANEZA Member 207-577-9756 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
Enumeration Date | 2023-05-19 |
Last Update Date | 2023-05-19 |