| NPI | 1790956365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT NIEBURG President 860-599-2125 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 000880) |
| Enumeration Date | 2008-03-21 |
| Last Update Date | 2008-03-21 |