| NPI | 1790321578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WHEELER Owner 207-459-4664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2019-11-26 |