| NPI | 1811633944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMY VAN WYCK BORBIDGE Manager 603-568-9257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |