| NPI | 1053785832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON P. DONAHUE Interim CFO 860-550-7524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care (Licence: CT 0312) |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |