| NPI | 1205174745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MAJKA CFO/Cso 802-885-7629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-01-17 |
| Last Update Date | 2013-03-07 |