| NPI | 1477980126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROXANNE KIEDA POMEROY Owner 860-323-0633 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 001457) |
| Enumeration Date | 2013-09-26 |
| Last Update Date | 2013-09-26 |