| NPI | 1023605334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY PRATT Administrator 603-338-0033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2020-12-22 |
| Last Update Date | 2022-04-29 |