| NPI | 1770309551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKITA DRAKE Clinician 207-219-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2024-11-26 |