| NPI | 1659097749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIELS YORK Sole Member 603-918-9888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2023-01-11 |