| NPI | 1497251623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA MICHELLE ALSTON Owner 860-212-6764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 1176) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2018-04-05 |