| NPI | 1972013415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN MADELEINE SMITH Owner 475-331-2100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: CT 008381) |
| Additional Taxonomies | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: CT 008381) |
| Enumeration Date | 2017-10-11 |
| Last Update Date | 2017-10-11 |