| NPI | 1649519885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT CARRA Authorized Official 860-698-1150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MA 117430) |
| Enumeration Date | 2013-02-07 |
| Last Update Date | 2025-03-06 |