| NPI | 1154034411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FARRELL CEO 207-796-5503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2024-12-11 |