| NPI | 1790211779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY GREKULA Pharmacist 860-785-6052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0013767) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |