| NPI | 1942025804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA POLEPOLE TELUDJI Business Manager 603-716-4968 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251T00000X PACE Provider Organization |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 253Z00000X In Home Supportive Care | |
| Enumeration Date | 2024-11-16 |
| Last Update Date | 2024-11-16 |