| NPI | 1750037024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN CHRISTOPHER BURO Manager 207-910-6580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2022-02-25 |
| Last Update Date | 2023-08-03 |