| NPI | 1003209115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ELIZABETH BRADY Owner 860-888-2516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 008089) |
| Enumeration Date | 2015-03-13 |
| Last Update Date | 2019-04-26 |