| NPI | 1477607042 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN DALE FERGUSON Business Manager 603-433-6250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2019-02-28 |