LOCAL ROOTS HEALTH CARE PLLC NPI 1609468347

NPI Information

NPI: 1609468347
Provider Name: LOCAL ROOTS HEALTH CARE, PLLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 20D2214066

Address:
12 DEPOT ST
KENNEBUNK, ME
ZIP 04043
Phone: (207) 569-2021
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LOCAL ROOTS HEALTH CARE, PLLC is a primary care clinic center in Kennebunk, ME. LOCAL ROOTS HEALTH CARE, PLLC NPI is 1609468347. The provider is registered as an organization entity type.

The provider's business location address is:

12 DEPOT ST
KENNEBUNK, ME
ZIP 04043-038
Phone: (207) 569-2021
Fax: (207) 203-4641

The provider's authorized official is Kyle Anders Holmquist .
The authorized official title is Managing Member and has the following contact phone number (207) 929-0170.

The CLIA number assigned to this NPI record is 20D2214066 - other - primary care clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/4/2021 and was last updated on 9/25/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			No
2	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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