| NPI | 1255711107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAN GOUSE CEO 860-270-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: CT 3455) |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2015-06-05 |