| NPI | 1871545939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE JAMES WALLINGTON Member 860-670-5596 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 031694) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |