| NPI | 1790383693 |
|---|---|
| Doing Business As | BANYAN HEALTH |
| Entity Type | Organization |
| Authorized Contact | LOUIS B. OTT President 207-712-1531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-10-13 |
| Last Update Date | 2020-10-13 |