| NPI | 1831174614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FARRELL CEO 207-796-5503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 152W00000X Optometrist |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2025-03-04 |