NPI | 1023650090 |
---|---|
Entity Type | Organization |
Authorized Contact | BRITTNEY JACKSON Member 203-699-6318 |
Organization Subpart ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 251S00000X Community/Behavioral Health |
261QM0801X | |
Enumeration Date | 2019-10-11 |
Last Update Date | 2022-01-24 |