| NPI | 1174741094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER PELLETIER CEO 207-834-3971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2022-11-17 |