| NPI | 1457823692 |
|---|---|
| Former Legal Business Name | MANAGER |
| Entity Type | Organization |
| Authorized Contact | SAMUEL TWUMASI Manager 860-819-8954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2018-12-28 |
| Last Update Date | 2018-12-28 |