| 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 |