| NPI | 1619296696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY RANARD Owner 860-919-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: 001581) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 000816) |
| Enumeration Date | 2010-05-31 |
| Last Update Date | 2010-05-31 |