| NPI | 1659923068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAINE LINTON Owner 207-402-4890 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2020-02-06 |