| NPI | 1811303373 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANCE W JORDAN CEO 207-808-1384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME CNP81017) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC2233) |
| Enumeration Date | 2014-07-06 |
| Last Update Date | 2020-10-15 |