| NPI | 1831639426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN T GRANAHAN President/General Counsel 718-784-2240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2022-11-10 |