| NPI | 1073526968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK LAVELLE Director Of Project Management 203-772-1270 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 103TC0700X Psychologist Clinical | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2022-03-07 |