| NPI | 1699764852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BRENT CASTON Billing Manager 207-255-0763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: ME 225422) |
| Enumeration Date | 2005-10-19 |
| Last Update Date | 2024-02-07 |