| NPI | 1114460284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW EACOTT Vice President, Officer 203-779-5799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |