| NPI | 1407331978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GARCA Billing Manager 603-162-5765 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2019-02-25 |