| NPI | 1932870391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE FENTON Licensed Clinical Social Worker 860-778-0363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2021-09-25 |
| Last Update Date | 2021-09-25 |