| NPI | 1598283806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KEARNS Credentialer 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 |