| NPI | 1245521970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN GRIMAUD CEO 860-482-3038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT Pending) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |