| NPI | 1679165070 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVON LEIGH BRIEM Owner 860-839-1295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-02-07 |
| Last Update Date | 2021-02-07 |