| NPI | 1790156792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIRDRE SULKA-MEISTER Owner 207-761-4700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: ME CNP111057) |
| Enumeration Date | 2015-10-15 |
| Last Update Date | 2015-11-05 |