| Organization Name: | PMC MEDICAL GROUP, LLC |
| NPI Number: | 1396121240 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHANIE CAUCIS (COO) |
| Mailing Address: | 7 Works Way Somersworth |
| State: | NH US |
| Postal Code: | 038781639 |
| Phone Number: | 6036923166 |
| Fax Number: | 6036923168 |
| NPI Enumeration Date: | 08/03/2015 |
| NPI Last Update Date: | 08/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |