| NPI | 1942723283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK JOSEPH ROACH Owner 207-459-8378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2017-07-19 |