| NPI | 1104941806 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOL MARIA GONZALEZ Credentialing Specialist 203-503-3174 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: CT SA-0122) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2020-04-30 |