| NPI | 1285313643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIAN EVERETT LOGAN Chief Of Operations And Enrollment 603-989-3500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-07-13 |