| NPI | 1659811040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS TOMCZAK Owner 860-916-1816 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 001209) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2017-03-24 |