| NPI | 1952882433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLLEEN CANAWAY Credentialing/Contracting 603-882-3616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 251K00000X Public Health or Welfare | |
| 251S00000X | |
| Enumeration Date | 2018-08-23 |
| Last Update Date | 2018-08-23 |