| NPI | 1316203706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK CHRISTOPHER GIBBS President / C.E.O. 860-346-0771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 305R00000X Preferred Provider Organization |
| 1041C0700X Social Worker, Clinical | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2015-05-13 |