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Organization
AGING GRACE HOUSE CALLS, PROFESSIONAL CORPORATION
Active
Organization
AGING GRACE HOUSE CALLS, PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN M MORDINO ANP-BC (CEO)
(617) 435-7601
Entity
Organization
Contact information
Practice address
21 E SUMMER ST, BANGOR, ME 04401-5513
(207) 573-0710
Mailing address
21 E SUMMER ST, BANGOR, ME 04401-5513
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Enumeration date
01/04/2024
Last updated
02/26/2024
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