| NPI | 1386265023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF PARK Manager 603-254-2808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Enumeration Date | 2020-05-05 |
| Last Update Date | 2020-05-05 |