| NPI | 1023675873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAILA HAROON Credentialing Specialist 203-332-3564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-05-28 |
| Last Update Date | 2019-05-28 |