| NPI | 1912489626 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONIA MYSHRALL Owner 860-830-0307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1141) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2018-08-30 |