| NPI | 1952653065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS W. WHITE Director 603-986-6051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NH 284) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: ME LC00006034) |
| Enumeration Date | 2012-10-12 |
| Last Update Date | 2012-10-12 |