| NPI | 1265936322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE TIMMINS Credentialing Specialist 603-882-3616 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-03-22 |
| Last Update Date | 2018-03-22 |