| NPI | 1265626899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE MARIE PAGE Clinical Social Worker / Vice Presi 860-889-4944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 251S00000X (Licence: CT 1041C0700x) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2013-04-30 |