Organization
LICENSED SUPPORT CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YOCHEVED WASSERMAN (PRESIDENT)
(845) 596-2271
Entity
Organization
Contact information
Practice address
283 SCENIC DRIVE, MANCHESTER, NH 03103
(845) 596-2271
Mailing address
283 SCENIC DRIVE, MANCHESTER, NH 03103
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/10/2023
Last updated
05/10/2023
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