NPI | 1477886174 |
---|---|
Entity Type | Organization |
Authorized Contact | JILL R. CRISTO President 860-463-6723 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CT 000717) |
Enumeration Date | 2009-09-12 |
Last Update Date | 2009-09-12 |