| NPI | 1912367194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAMISHA S CORLEY Clinical Supervisor 860-528-4037 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: CT 1417097593) |
| Enumeration Date | 2016-03-01 |
| Last Update Date | 2016-03-01 |