| Associated Community Action Of The North East Adirondack Region, Inc. | |
|
39 Farrell Rd Willsboro NY 12996-3904 | |
| (518) 963-4275 | |
| Not Available |
| Full Name | Associated Community Action Of The North East Adirondack Region, Inc. |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 39 Farrell Rd, Willsboro, New York |
| Authorized Official Name and Position | Robin A. Pierce (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5189634275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Associated Community Action Of The North East Adirondack Region, Inc. 39 Farrell Rd Willsboro NY 12996-3904 Ph: (518) 963-4275 | Associated Community Action Of The North East Adirondack Region, Inc. 39 Farrell Rd Willsboro NY 12996-3904 Ph: (518) 963-4275 |
| NPI Number | 1902960610 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 08/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902960610 | NPI | - | NPPES |
| 00473478 | Medicaid | NY | |
| FQHCLA218 | Other | NY | 340B ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 1566200R (New York) | Primary |