| NPI | 1770956393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH A OLSON Executive Dir/Clinical Dir Me 207-776-1351 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X (Licence: ME 322081) |
| Enumeration Date | 2015-11-04 |
| Last Update Date | 2015-11-04 |