| 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 |