| NPI | 1053063107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLAUDETTE G HUMPHREY CEO 207-528-2285 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2022-01-20 |
| Last Update Date | 2022-03-12 |