| 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 |