NPI | 1811404098 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSICA PACKARD Owner 207-504-3587 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: ME CC4601) |
Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health (Licence: ME CC4601) |
261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: ME CC4601) | |
Enumeration Date | 2018-01-09 |
Last Update Date | 2018-01-09 |