| NPI | 1588319511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENEESE CHARLES Founder/Owner 860-515-8623 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2022-02-17 |