| NPI | 1508916636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GARCA Billing Manager 603-516-2576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2018-08-16 |