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 |