| Organization Name: | CHARLOTTE WHITE CENTER |
| NPI Number: | 1649337197 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LYNN M LAMB (CREDENTIALING COORDINATOR) |
| Mailing Address: | 59 River St Dover Foxcroft |
| State: | ME US |
| Postal Code: | 044261322 |
| Phone Number: | 2075642464 |
| Fax Number: | 2075642404 |
| NPI Enumeration Date: | 01/03/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0405X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Substance Use Disorder |
| Taxonomy Definition: | |