| NPI | 1861843864 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA LEA TONER Owner/Licensee 860-351-3011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 00295) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 00295) |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: CT 00295) | |
| 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient (Licence: CT 00295) | |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2016-06-30 |