| NPI | 1124579784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID HORN Clinician 203-776-8390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 000393) |
| Enumeration Date | 2016-10-19 |
| Last Update Date | 2016-10-19 |