| NPI | 1639339948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY GARCA Billing Manager 603-812-0833 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2022-02-01 |