| NPI | 1346641313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDI KOSAKOWSKI Administrator/Third Party Billing 603-353-9102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: MA 0203) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |