| NPI | 1750992244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRNEL GEGU Social Worker 860-967-1126 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-08-10 |
| Last Update Date | 2020-08-10 |