Organization
CENTER FOR SACRED LIVING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEBRA GRETEN-GANBERG LCSW (DIRECTOR OF CLINICAL SERVICES)
(207) 221-0727
Entity
Organization
Contact information
Practice address
69 ANGELL AVE, APT 1, SOUTH PORTLAND, ME 04106-5002
(207) 221-0727
Mailing address
69 ANGELL AVE, APT 1, SOUTH PORTLAND, ME 04106-5002
(207) 221-0727
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
AC1
ME
251S00000X
Community/Behavioral Health Agency
Primary
LC6487
ME
Other
Enumeration date
06/19/2009
Last updated
06/19/2009
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