| NPI | 1043684145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY TAYLOR Therapist 860-550-1490 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 2901) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CT 001166) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 001166) | |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 2901) | |
| Enumeration Date | 2015-11-30 |
| Last Update Date | 2016-02-05 |