Provider First Line Business Practice Location Address:
401 WEST THAMES ST, BLDG 301
Provider Second Line Business Practice Location Address:
SOUTHEASTERN MENTAL HEALTH AUTHORITY
Provider Business Practice Location Address City Name:
NORWICH
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06360
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-859-4629
Provider Business Practice Location Address Fax Number:
860-859-4725
Provider Enumeration Date:
11/07/2012