| NPI | 1346210135 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JEFFREY S. BRAVIN Executive Director 860-570-1816 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 231H00000X Audiologist | |
| 235Z00000X Speech-Language Pathologist, | |
| 363L00000X Nurse Practitioner | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2006-01-24 | 
| Last Update Date | 2022-02-16 |