| NPI | 1831297704 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY E FABACHER Owner 239-261-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: FL ME 0055928) |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2020-08-22 |