NPI | 1710185731 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM MARTIN Executive Director 860-442-9454 |
Organization Subpart ? | No |
Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility (Licence: CT CCF/RT#12) |
Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT OPCC-50) |
Enumeration Date | 2007-07-11 |
Last Update Date | 2017-02-28 |