| NPI | 1710623913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HAROLD SHIPPEE President/CEO 518-591-4459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-05-10 |
| Last Update Date | 2022-05-10 |