| NPI | 1083022230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON THOMPSON CEO 203-756-8021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: CT 0479) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: CT 0479) |
| 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: CT 0479) | |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2018-02-12 |