| NPI | 1629851761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLEEN L ELIAS CEO 207-513-3897 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2024-04-05 |