| NPI | 1720492614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW PAUL BOHONOWICZ Therapist Mediator 860-890-8689 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 002174) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |