| NPI | 1699445361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALANE O'CONNOR Owner 207-558-6124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-09-15 |
| Last Update Date | 2021-09-15 |