| NPI | 1144040031 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HAROLD SHIPPEE President/CEO 518-591-4459 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-10-15 |
| Last Update Date | 2024-10-15 |