| NPI | 1205583895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE E BLAKE Sole Member/Owner 603-860-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261Q00000X Clinic/Center | |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2022-12-22 |