| NPI | 1215284427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA WAYNE Owner 860-309-7262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 000360) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CT 000935) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000935) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2012-10-12 |