| NPI | 1033750484 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT R. UNTCH CFO 603-335-8151 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 273R00000X Psychiatric Unit |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2020-10-22 |