| NPI | 1801411913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET LAATSCH CEO 603-749-2346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-06-15 |
| Last Update Date | 2020-06-19 |