| NPI | 1205374907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY PINNER Member 860-917-0923 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 1-14-10399) |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2017-02-02 |