| NPI | 1376801472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN DIAZ Owner/Clinician 860-922-5034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 000887) |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2022-03-31 |