NPI | 1225400237 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL GARDNER Finance Director 802-855-2083 |
Organization Subpart ? | Yes |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Additional Taxonomies | 207Q00000X Family Medicine |
Enumeration Date | 2015-10-29 |
Last Update Date | 2018-02-19 |