| NPI | 1417389636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANATOLIY RAVIN Owner 860-524-5194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: CT 008890) |
| Enumeration Date | 2013-07-31 |
| Last Update Date | 2013-07-31 |