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Organization

POSITIVE CHANGE IN ACTION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DIANA POLEPOLE TELUDJI (BUSINESS MANAGER)
(603) 716-4968
Entity
Organization

Contact information

Practice address
89 SUMMERSIDE AVE, MANCHESTER, NH 03102-4929
(603) 512-1942
Mailing address
89 SUMMERSIDE AVE, MANCHESTER, NH 03102-4929
(603) 512-1942

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
251T00000X
PACE Provider Organization
Primary
253Z00000X
In Home Supportive Care Agency

Other

Enumeration date
11/16/2024
Last updated
11/16/2024
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