| NPI | 1043762685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUSSELL KEENE Executive Director 603-934-1464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2024-05-17 |