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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MOHAMED JAMA ABDI (ADMINISTRATOR)
(207) 347-6106
Entity
Organization

Contact information

Practice address
999 FOREST AVE, 207, PORTLAND, ME 04103-3366
(207) 347-6113
(207) 347-6113
Mailing address
999 FOREST AVE, 207, PORTLAND, ME 04103-3366
(207) 347-6113
(207) 347-6113

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
02915
ME

Other

Enumeration date
04/27/2009
Last updated
04/27/2009
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