| NPI | 1740643071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK GAGNON Owner 475-225-0537 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: CT 000894) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |