| NPI | 1689233512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASMO DOL Program Director 207-754-9115 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |