| NPI | 1184886988 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI WARNER Director Revenue Cycle Management 315-476-7921 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2024-06-05 |