| NPI | 1891872842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDITH A KUILAN Billing 860-676-9350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2018-04-17 |