| NPI | 1013379767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY AMBROISE Owner/Manager 203-952-1900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 002893) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2016-03-22 |