| NPI | 1184702821 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLEEN L ELIAS CEO/CFO 207-513-3897 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-10-22 |