| NPI | 1043795834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACOB PISTOR CEO 203-581-4118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2023-06-26 |