| NPI | 1336465947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M CARON COO 207-498-2356 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 208M00000X Hospitalist | |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | |
| Enumeration Date | 2010-04-08 |
| Last Update Date | 2013-07-08 |