| NPI | 1740528967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD FAROOQ DADA Physician 860-523-9426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 040063) |
| Additional Taxonomies | 283Q00000X Psychiatric Hospital (Licence: CT 040063) |
| 314000000X Skilled Nursing Facility (Licence: CT 040063) | |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2015-08-12 |