| NPI | 1770794661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN L RANDLETT Sole Proprietor 603-456-2004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NH 433) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |