Organization
CAMP KETCHA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS DOHERTY MSW (EXECUTIVE DIRECTOR)
(207) 883-8977
Entity
Organization
Contact information
Practice address
336 BLACK POINT RD, SCARBOROUGH, ME 04074-8676
(207) 883-8977
(207) 885-0944
Mailing address
336 BLACK POINT RD, SCARBOROUGH, ME 04074-8676
(207) 883-8977
(207) 885-0944
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
681191
ME
Other
Enumeration date
06/05/2014
Last updated
06/05/2014
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