# MANCHESTER YOUTH ALLIANCE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386265023
- **Authorized official:** JEFF PARK (MANAGER)
- **Authorized official phone:** (603) 254-2808

## Contact information

- **Practice address:** 1056 RIVER RD, MANCHESTER, NH 03104-1958
- **Practice address phone:** (603) 353-9102
- **Practice address fax:** (603) 353-9412
- **Mailing address:** PO BOX 325, ORFORD, NH 03777-0325
- **Mailing address phone:** (603) 353-9102
- **Mailing address fax:** (603) 353-9412

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | — | Yes |

## Other

- **Enumeration date:** 05/05/2020
- **Last updated:** 05/05/2020