| NPI | 1740683580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRAINE JAMISON Clinical Director 860-796-7696 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CT 006664) |
| Additional Taxonomies | 251B00000X Case Management (Licence: CT 006664) |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2015-09-08 |