| NPI | 1275279697 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY J JESKI Licensed Clinical Social Worker 860-324-2840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2022-05-09 |