| NPI | 1205503471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA CAMPBELL Organizer 203-528-5447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2022-11-29 |