| NPI | 1780108399 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA BAXTER Chief Financial And Admin Officer 860-443-2896 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2019-06-20 |