| NPI | 1063782662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY MAGUDA Community Based Svcs Coordinator 860-878-6858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT opcc68) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0520) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: CT 0432) | |
| Enumeration Date | 2012-01-12 |
| Last Update Date | 2015-02-18 |