| NPI | 1154196376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELESTE MARIE MENDEZ Owner 860-878-8447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2023-11-17 |
| Last Update Date | 2024-06-20 |