| NPI | 1174056659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSAY S PENEV Clinician 203-747-2851 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 001124) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2017-04-11 |