Portland Community Health Center

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

PORTLAND COMMUNITY HEALTH CENTER

Practice address

166 Brackett St
Portland, ME 04102-3825

Phone

(207) 874-2141

NPI assigned

Sep 19, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Leslie Clark

Title

Ceo

Phone

(207) 874-2141

Specialties & licenses 1

Addresses

Other names 1

• Reiche Elementry School Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1474243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1474243200000",
    "number": "1760930739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 PARK AVE",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041022957",
            "telephone_number": "207-874-2141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 BRACKETT ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023825",
            "telephone_number": "207-874-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTLAND COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-19",
        "last_updated": "2016-09-19",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "207-874-2141",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Reiche Elementry School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center
• Portland Community Health Center

• Federally Qualified Health Center (FQHC) in Portland, ME
• Providers in Portland, ME by specialty
• Federally Qualified Health Center (FQHC) in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.