| NPI | 1386162634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KEARNS Credentialing Specialist 603-882-3616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0800X Clinic/Center, Recovery Care |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2017-09-07 |