| NPI | 1689182917 |
|---|---|
| Other Name | N/A |
| Entity Type | Organization |
| Authorized Contact | DANIEL P. MORIN Member 603-459-3071 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X (Licence: NH 022774-23) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: NH 022774-23) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2018-01-22 |