| NPI | 1205291317 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW MAJKA CFO 802-886-8950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2024-10-24 |