| NPI | 1215646179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIANNA THOMPSON Owner 203-979-9372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-12-07 |