| NPI | 1215441597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BRADWAY Director Information Systems 203-568-7466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CT 0533) |
| Enumeration Date | 2017-11-26 |
| Last Update Date | 2017-11-26 |