| NPI | 1649337197 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN M LAMB Credentialing Coordinator 207-564-2464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-08-22 |