| NPI | 1992750855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID SEMPLE CEO 860-550-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0259) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 0312) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2014-06-02 |