| NPI | 1093125064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA J PORTEUS Executive Director 203-759-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT 0571) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |