| NPI | 1528423134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOLLY K ROY Business Manager 860-559-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH9526) |
| Enumeration Date | 2015-12-24 |
| Last Update Date | 2025-08-07 |