| NPI | 1497796353 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRI D WARNER Director Of Revenue Cycle Managment 315-476-7921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2024-06-05 |