Organization
PORTLAND COMMUNITY HEALTH CENTER
Active
Other names
Lincoln Middle School
Organization subpart
No
Provider details
NPI number
Authorized official
ANN TUCKER (CFO)
(207) 874-2141
Entity
Organization
Contact information
Practice address
522 STEVENS AVE, PORTLAND, ME 04103-2611
(207) 874-2141
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
03/20/2017
Last updated
06/09/2023
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