| NPI | 1265015051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINI'IMAH WILSON Executive Director 860-209-6228 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 251K00000X Public Health or Welfare |
| 261QC1500X Clinic/Center, Community Health | |
| Enumeration Date | 2021-04-30 |
| Last Update Date | 2021-04-30 |