| NPI | 1366623951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT C. GOODWIN Managing Member 860-644-9191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 16361) |
| Enumeration Date | 2007-11-25 |
| Last Update Date | 2007-11-25 |