| NPI | 1780730267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD JOHNSON Executive Director 860-643-2101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT OPCC-14) |
| Additional Taxonomies | 261Q00000X (Licence: CT 0238) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2013-05-03 |