| NPI | 1174902084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID AVERSA Medical Director 203-298-9005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: CT 2422) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |