| NPI | 1225403710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LLOYD EZEKIEL CLOUD Administrator 860-301-1664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0904008979) |
| Additional Taxonomies | 251S00000X (Licence: CT 005725) |
| Enumeration Date | 2015-12-09 |
| Last Update Date | 2023-11-14 |