Organization
PASSAMAQUODDY TRIBAL COUNCIL
Active
Parent organization
PASSAMAQUODDY TRIBAL COUNCIL
Other names
PLEASANT POINT HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
PASSAMAQUODDY TRIBAL COUNCIL
Authorized official
CRYSTAL BORE (ADMIN ASSISTANT)
(207) 853-0555
Entity
Organization
Contact information
Practice address
11 BACK RD, PLEASANT POINT, ME 04667-4119
(207) 853-0644
(207) 853-2347
Mailing address
PO BOX 351, PERRY, ME 04667-0351
(207) 853-0644
(207) 853-2347
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
107300000
—
ME
05
—
107300100
—
ME
05
—
107300200
—
ME
Enumeration date
08/17/2005
Last updated
04/18/2024
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