Organization
CITY OF PORTLAND MAINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON P JENNINGS (CITY MANAGER)
(207) 874-8689
Entity
Organization
Contact information
Practice address
166 BRACKETT ST, PORTLAND, ME 04102-3825
(207) 874-8786
(208) 874-8447
Mailing address
389 CONGRESS ST, ROOM 307, PORTLAND, ME 04101-3566
(207) 874-8784
(207) 874-8913
Taxonomy
Speciality
Code
Description
License number
State
261QP0905X
State or Local Public Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136040603
—
ME
Enumeration date
03/27/2009
Last updated
10/06/2015
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