NPI | 1811387012 |
---|---|
Other Name | N/A |
Entity Type | Organization |
Authorized Contact | MICHAEL WEINBERG Manager 860-315-0565 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 002562) |
Enumeration Date | 2015-01-27 |
Last Update Date | 2015-01-27 |