Organization
INDIAN TOWNSHIP TRIBAL GOVERNMENT
Active
Parent organization
PASSAMAQUODDY HEALTH CENTER
Other names
PASSAMAQUODDY HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PASSAMAQUODDY HEALTH CENTER
Authorized official
ANDREA M HANSON TRIBAL CHIEF (COMPLIANCE SPECIALIST)
(207) 796-2321
Entity
Organization
Contact information
Practice address
401 PETER DANA POINT ROAD, PRINCETON, ME 04668-0097
(207) 796-2321
(207) 796-2422
Mailing address
PO BOX 97, 401 PETER DANA POINT RD, PRINCETON, ME 04668-0097
(207) 796-2321
(207) 796-2422
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107940000
—
ME
Enumeration date
03/22/2007
Last updated
09/28/2020
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