| NPI | 1891454765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARISSE FAIRBANKS Owner, Authorized Official 860-414-4787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2024-07-01 |