| NPI | 1811404098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA PACKARD Owner 207-504-3587 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (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 |