MAINE MOBILE HEALTH PROGRAM, INC.
NPI 1376829598
Clinic/Center - Federally Qualified Health Center (FQHC) in Augusta, ME

Active since November 02, 2011CLIA 20D1050279 · Waiver
79 LEIGHTON RD, AUGUSTA, ME 04330(207) 622-9252(207) 626-7612 Get Directions Write a Review

NPPES record last updated: October 2, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 13, 2023, Oct 18, 2017 (2 updates tracked since 2017).

About Maine Mobile Health Program, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAINE MOBILE HEALTH PROGRAM, INC. (NPI 1376829598) is a healthcare organization registered as a federally qualified health center (fqhc) in Augusta, Maine and active in the NPI registry since November 2011. The organization holds a CLIA Waiver certificate valid through January 29, 2028 and lists Amelia Rukema, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1376829598
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameMAINE MOBILE HEALTH PROGRAM, INC.
Location Address79 LEIGHTON RDAugusta, ME 04330-7747
Mailing AddressPo Box 405Augusta, ME 04332-0405 · (207) 622-9252 · Fax (207) 626-7612
Fax(207) 626-7612
Organization SubpartNo
Authorized OfficialAmelia RukemaChief Executive Officer · (207) 557-0870
Enumeration DateNovember 2, 2011
Last NPPES UpdateOctober 2, 20252 updates tracked since enumeration
NPPES CertifiedOctober 2, 2025
NPI 1376829598 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
79 LEIGHTON RD, Augusta, ME 04330

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 20D1050279

Maine Mobile Health Program · Augusta, ME
Active · expires Jan 29, 2028
CLIA Number20D1050279
Laboratory TypeFederally Qualified Health Center
Certificate Effective DateJanuary 30, 2026
Certificate Expiration DateJanuary 29, 2028
Laboratory DirectorDemetri Blanas
Laboratory Phone(207) 622-9252
Laboratory LocationMaine Mobile Health Program79 Leighton Rd PO Box 405, Augusta, ME 04330
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Maine Mobile Health Program, Inc.'s NPI number?

The NPI number for Maine Mobile Health Program, Inc. is 1376829598. It was assigned to this organization in the NPPES registry on November 2, 2011.

Where is Maine Mobile Health Program, Inc. located?

Maine Mobile Health Program, Inc. is located at 79 Leighton Rd, Augusta, ME 04330. The listed phone number is (207) 622-9252.

What is Maine Mobile Health Program, Inc.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

Does Maine Mobile Health Program, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 20D1050279) is associated with this NPI, valid through January 29, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Maine Mobile Health Program, Inc. was last updated on October 2, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.