| NPI | 1639896533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIPAK DATTANI Director 207-245-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-10-21 |
| Last Update Date | 2022-10-21 |