| NPI | 1013419357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANA S HILERIO Manager 860-593-7243 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 009094) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2019-08-23 |