| NPI | 1215979810 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM KENNEDY Executive Assistant 860-697-3364 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT OPCC-73) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2006-06-11 |
| Last Update Date | 2020-10-01 |