NPI | 1750807426 |
---|---|
Entity Type | Organization |
Authorized Contact | SARAH JONES Credentialing Specialist 860-343-5500 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0635) |
Enumeration Date | 2017-08-15 |
Last Update Date | 2019-06-11 |