| NPI | 1710415658 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BADEAU Owner 860-810-5915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: 001364) |
| Enumeration Date | 2017-05-23 |
| Last Update Date | 2017-05-23 |