| NPI | 1770102089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON D BISHOP Chief Program Officer 207-602-8683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2025-06-05 |