Healthcare Provider Details

I. General information

NPI: 1659354116
Provider Name (Legal Business Name): AROOSTOOK COUNTY ACTION PROGRAM
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 FRENCHVILLE RD
FORT KENT ME
04743-1722
US

IV. Provider business mailing address

PO BOX 1116
PRESQUE ISLE ME
04769-1116
US

V. Phone/Fax

Practice location:
  • Phone: 207-834-3513
  • Fax: 207-834-3513
Mailing address:
  • Phone: 207-768-3056
  • Fax: 207-768-3022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LINDA MOUNTAIN
Title or Position: CLINIC COORDINATOR
Credential:
Phone: 207-768-3056