| NPI | 1497512198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS THERIAULT CEO 603-440-8618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-07-15 |