| NPI | 1225334162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA DONOHUE FREDETTE Clinician 860-262-5244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 007297) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2011-02-09 |