| NPI | 1952735995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RILWAN OSMAN Executive Director 207-753-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: ME 669694) |
| Additional Taxonomies | 251S00000X (Licence: ME 669694) |
| Enumeration Date | 2013-08-27 |
| Last Update Date | 2018-05-15 |