| NPI | 1902243835 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI OREND Member Manager 860-754-4091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 4950) |
| Enumeration Date | 2013-06-01 |
| Last Update Date | 2013-06-01 |