| NPI | 1023522927 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA FASCIANO Manager 203-530-6979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health (Licence: MA 10123) |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |