| NPI | 1760541510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WARREN CORSON Executive & Clinical Director 860-582-7904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CT 001465) |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2020-08-22 |