Organization
CROTCHED MOUNTAIN COMMUNITY CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARA NICKULAS (EXECUTIVE DIRECTOR)
(603) 831-8657
Entity
Organization
Contact information
Practice address
186 GRANITE ST STE 3C, MANCHESTER, NH 03101-2643
(603) 668-7584
(603) 431-5935
Mailing address
186 GRANITE ST STE 3C, MANCHESTER, NH 03101-2643
(603) 668-7584
(603) 431-5935
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
03262
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3079997
—
NH
Enumeration date
05/08/2007
Last updated
01/17/2024
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