| NPI | 1811342827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY OSBORNE CEO 607-753-3797 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2022-01-19 |