| 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 |