| NPI | 1699307686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAUNA LEIGH BISSON Managing Member 860-919-0362 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-02-07 |
| Last Update Date | 2020-02-13 |