| NPI | 1194396234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN DEJESUS Licensed Professional Counselor 860-716-3081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-07-09 |
| Last Update Date | 2021-07-09 |