| NPI | 1679047872 |
|---|---|
| Doing Business As | GREATER PORTLAND HEALTH LOGAN PLACE |
| Entity Type | Organization |
| Authorized Contact | ANN F TUCKER CEO 207-874-2141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| Enumeration Date | 2019-01-22 |
| Last Update Date | 2023-06-09 |