| NPI | 1972029643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH JONES Credentialing Specialist 860-343-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: CT 0627) |
| Enumeration Date | 2017-08-15 |
| Last Update Date | 2019-06-11 |