| NPI | 1316197965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIANNE R. CARROLL Manager 860-423-4279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000055) |
| Additional Taxonomies | 251S00000X (Licence: CT 003025) |
| 1041C0700X Social Worker, Clinical (Licence: CT 003025) | |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2014-10-05 |