| NPI | 1912769340 |
|---|---|
| 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) |
| Enumeration Date | 2024-01-30 |
| Last Update Date | 2024-01-30 |