| NPI | 1437465309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEAH ANN VALENZA RUSSACK-BAKER Clinical Director 860-984-1281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 000793) |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2010-08-30 |