| NPI | 1932438553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BENEDICT Executive Director 860-343-0402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2009-12-10 |
| Last Update Date | 2023-07-12 |