NPI | 1295336329 |
---|---|
Entity Type | Organization |
Authorized Contact | TANGIE R MCDOUGALD Licensed Professional Counselor 860-282-8882 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X |
Additional Taxonomies | 261Q00000X Clinic/Center |
261QC1500X Clinic/Center, Community Health | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2020-11-04 |
Last Update Date | 2020-11-04 |