| NPI | 1144296815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA J COOK Acting CEO 203-483-2630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT C-0193) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 0319) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2020-08-22 |