| NPI | 1083864458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID H SHIPPEE CEO 518-465-4771 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2019-06-20 |