| None | |
|
999 Forest Ave Suite 7 Portland ME 04103-3366 | |
| (207) 344-5971 | |
| (207) 536-1591 |
| Full Name | None |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 999 Forest Ave, Portland, Maine |
| Authorized Official Name and Position | Abdullahi Alibare (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2073445971 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| None 999 Forest Ave Suite 7 Portland ME 04103-3366 Ph: (207) 344-5971 | None 999 Forest Ave Suite 7 Portland ME 04103-3366 Ph: (207) 344-5971 |
| NPI Number | 1083082630 |
|---|---|
| Provider Enumeration Date | 09/11/2015 |
| Last Update Date | 09/11/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083082630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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