| NPI | 1093451148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATACHA JACKSON Owner / Ladc 203-490-8539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-05-11 |
| Last Update Date | 2022-05-11 |