| NPI | 1841684164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY EDWARD DRISCOLL Clinical Social Worker 860-309-7034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 000209) |
| Enumeration Date | 2015-03-25 |
| Last Update Date | 2015-04-17 |