| NPI | 1508160631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER S BOSCO Member/Owner 860-662-1933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 001695) |
| Enumeration Date | 2011-01-04 |
| Last Update Date | 2018-08-15 |