| NPI | 1003119140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AJMAL MEHDI Cna,Pct, Manager 860-583-3338 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: CT HCA.0000440) |
| Additional Taxonomies | 251E00000X Home Health (Licence: CT NA9992331) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2010-12-13 |