| NPI | 1669039178 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACIE L LECLERC Owner 603-356-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103T00000X Psychologist | |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) | |
| 106H00000X Marriage & Family Therapist | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2022-08-01 |