| NPI | 1912448465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG ALAN SMITH CEO 860-748-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 002192) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 002192) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |