| NPI | 1649841925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINIQUE MAZAMBO CFO 207-409-2798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2021-07-13 |