| Organization Name: | HUDSON HEADWATERS HEALTH NETWORK, INC. |
| NPI Number: | 1013292002 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHRISTOPHER TOURNIER (CFO) |
| Mailing Address: | 161 Carey Rd Queensbury |
| State: | NY US |
| Postal Code: | 128047821 |
| Phone Number: | 5188248610 |
| Fax Number: | 5188242390 |
| NPI Enumeration Date: | 10/21/2011 |
| NPI Last Update Date: | 08/28/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | 5660200R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |