| NPI | 1700539962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIDGETTE MONTGOMERY Owner 860-692-2033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282J00000X Religious Nonmedical Health Care Institution |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-01-28 |