| NPI | 1205109667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENA HOPE RUSSO Licsensed Clinical Social Worker 860-874-7149 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CO 1957) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2012-02-15 |