| NPI | 1033750526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE PHILLIPS Owner 860-729-7239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2019-10-05 |
| Last Update Date | 2019-10-05 |