| NPI | 1093709370 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES M HARRIS Regional Director Of Reimbursement 860-714-4396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: MA 4257) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2019-04-12 |