Organization
MAPS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETER DANIEL RAND (DIRECTOR OF FINANCE)
(207) 775-7444
Entity
Organization
Contact information
Practice address
107 INDIA ST, PORTLAND, ME 04101-4211
(207) 775-7444
Mailing address
107 INDIA ST, PORTLAND, ME 04101-4211
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431730800
—
ME
Enumeration date
03/25/2009
Last updated
03/25/2009
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