NPI | 1518283126 |
---|---|
Entity Type | Organization |
Authorized Contact | LISA M CARON COO 207-498-2356 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 1041C0700X Social Worker Clinical |
363A00000X Physician Assistant | |
207Q00000X Family Medicine | |
363LF0000X Nurse Practitioner Family | |
Enumeration Date | 2010-04-08 |
Last Update Date | 2013-08-27 |