NPI | 1639177926 |
---|---|
Entity Type | Organization |
Authorized Contact | ALLEN S. GOUSE Executive Director 860-714-9501 |
Organization Subpart ? | No |
Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: CT 074502) |
Enumeration Date | 2005-07-11 |
Last Update Date | 2012-12-07 |