| NPI | 1841551553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUHAIL RODRIGUEZ Clinical Supervisor 860-692-1002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |