| NPI | 1487193611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA A COPPOLA Counselor 603-571-0994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 10015) |
| Enumeration Date | 2017-02-21 |
| Last Update Date | 2017-02-21 |