| NPI | 1063908507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ASHLEY GIRARD Owner 203-423-3546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1206) |
| Additional Taxonomies | 251S00000X (Licence: CT 1206) |
| 251S00000X | |
| Enumeration Date | 2018-07-09 |
| Last Update Date | 2018-07-09 |