| NPI | 1619196409 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD D SHANSHALA II Director 603-444-2464 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2009-03-16 |