| NPI | 1861624256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLANDO MARTINEZ Executive Director 860-527-1124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT 101YM0800X) |
| Enumeration Date | 2009-08-18 |
| Last Update Date | 2009-08-18 |