| NPI | 1154061554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SHIPPEE President And CEO 518-591-4459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-04-01 |
| Last Update Date | 2022-04-01 |