Organization
MANNA INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM RAE (CEO)
(207) 990-2870
Entity
Organization
Contact information
Practice address
629 MAIN ST, BANGOR, ME 04401-6848
(207) 990-2870
Mailing address
629 MAIN ST, BANGOR, ME 04401-6848
(207) 990-2870
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
CAC4364
ME
Other
Enumeration date
05/24/2013
Last updated
05/24/2013
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