| NPI | 1639654643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN CANAWAY Credentialing/Contracting 603-882-3616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| Enumeration Date | 2018-09-26 |
| Last Update Date | 2018-09-26 |