| NPI | 1902230766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN L LEVINE Counselor 860-810-3915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 000580) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |