| NPI | 1619415213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK PETER CRANDALL Counselor 603-781-4629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: TX 3767-3768) |
| Enumeration Date | 2017-02-03 |
| Last Update Date | 2017-02-03 |