| NPI | 1659716405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN HOCKING Assistant Executive Director 860-388-9656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2021-10-18 |