| NPI | 1669919874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY GOODELL Clinician 207-657-7700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ME LC16462) |
| Enumeration Date | 2017-01-25 |
| Last Update Date | 2017-01-25 |