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Organization

PORTLAND COMMUNITY HEALTH CENTER

Active
Parent organization
PORTLAND COMMUNITY HEALTH CENTER
Other names
Casco Bay High
Organization subpart
Yes

Provider details

NPI number
Legal business name
PORTLAND COMMUNITY HEALTH CENTER
Authorized official
MS. ANN TUCKER (CFO)
(207) 874-2141
Entity
Organization

Contact information

Practice address
196 ALLEN AVE, PORTLAND, ME 04103-3711
(207) 842-4693
Mailing address
180 PARK AVE, PORTLAND, ME 04102-2957
(207) 874-2141

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Enumeration date
08/06/2016
Last updated
06/09/2023
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