| NPI | 1932162674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LEVENSON Director 603-624-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: MA 3283749465) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: NH 011837-23-03) |
| Enumeration Date | 2006-04-11 |
| Last Update Date | 2020-08-22 |