Organization
EAST GRAND HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRISCILLA KNIGHTS ADMINISTRATOR (ADMINISTRATOR)
(207) 448-2347
Entity
Organization
Contact information
Practice address
201 HOULTON RD, DANFORTH, ME 04424
(207) 448-2347
(207) 448-2313
Mailing address
201 HOULTON RD, DANFORTH, ME 04424
(207) 448-2347
(207) 448-2313
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104590000
—
ME
Enumeration date
06/26/2006
Last updated
01/06/2009
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