| NPI | 1467242552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON M BAKER Manager 860-881-1948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-05-12 |
| Last Update Date | 2025-05-12 |