| NPI | 1447812250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAMILLE A PAYNE Nurse Practitioner 860-322-1011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2019-09-06 |