| NPI | 1790540565 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHANNAH CACIO Nurse Practitioner 603-616-5906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X |
| 261QM0801X | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-02-20 |