| NPI | 1295020691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA MATTHEWS CFO 207-853-0180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2024-01-08 |