| NPI | 1285239228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLAS GAUGHAN Owner 860-634-0967 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-11-30 |
| Last Update Date | 2020-12-04 |