| NPI | 1861237752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A LEO Owner 207-612-1129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2024-07-08 |