| NPI | 1083778203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN GRIMAUD Executive Director 860-482-3038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CT 030852) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2020-08-22 |