| NPI | 1669966347 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA CLARK Owner 207-613-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2018-06-18 |