| NPI | 1205039260 |
|---|---|
| Other Name | NORTHSIDE |
| Entity Type | Organization |
| Authorized Contact | SOL MARIA GONZALEZ Credentialing Specialist 203-503-3174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CT c0264) |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2022-01-24 |