| NPI | 1841569639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA M QUICK Clinician 860-714-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 007823) |
| Enumeration Date | 2011-12-22 |
| Last Update Date | 2011-12-22 |